{
  "ptid_time": "128_S_2045_2010-11-30",
  "img_path": "/data/qiuhui/data/adni/images/128_S_2045/2010-11-30/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 82,658 mm³, 114.6% above the reference mean. With a Z-score of 2.75 (99.7th percentile), this represents significant enlargement; hippocampal volume measures 7,686 mm³, 1.7% above the reference mean. With a Z-score of 0.16 (56.5th percentile), this represents normal volume ; whole brain volume measures 1,184,960 mm³, 9.8% above the reference mean. With a Z-score of 1.27 (89.8th percentile), this represents mild enlargement; entorhinal cortex volume measures 4,997 mm³, 21.9% above the reference mean. With a Z-score of 1.48 (93.1th percentile), this represents mild enlargement; fusiform gyrus volume measures 23,041 mm³, 22.3% above the reference mean. With a Z-score of 1.90 (97.1th percentile), this represents moderate enlargement; middle temporal gyrus volume measures 23,766 mm³, 11.4% above the reference mean. With a Z-score of 1.02 (84.7th percentile), this represents mild enlargement. ",
  "text_data": "Age is 72.3 years. Gender is Male. Education: 16 years. MMSE: 27.0. MoCA: 27.0. Logical Memory: 10.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.48 SUVR (profound elevated); Amyloid beta: 725.10 pg/mL (normal ); Total tau: 210.80 pg/mL (normal ); Phosphorylated tau: 20.50 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (a marker of brain atrophy) alongside normal hippocampal volume and mildly to moderately enlarged cortical volumes (entorhinal cortex, fusiform gyrus, middle temporal gyrus). Cognitive scores (MMSE, MoCA) are within normal limits, and CSF biomarkers (Aβ, T-tau, P-tau) are normal, but AV45 (amyloid PET) is profoundly elevated, suggesting amyloid pathology despite normal CSF Aβ.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely amyloid-positive, non-amnestic subtype given preserved hippocampal volume but cortical amyloid burden).  \n\n**Confidence:** **Medium** (cognitive scores are normal, but ventricular enlargement and AV45 elevation suggest early neurodegenerative changes; clinical correlation is needed to confirm functional impact).",
  "timestamp": "2025-07-26T13:58:26.539872"
}