{
  "ptid_time": "041_S_4989_2012-10-19",
  "img_path": "/data/qiuhui/data/adni/images/041_S_4989/2012-10-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 15,133 mm³, 32.3% below the reference mean. With a Z-score of -0.81 (21.0th percentile), this represents normal volume ; hippocampal volume measures 8,013 mm³, 4.3% above the reference mean. With a Z-score of 0.48 (68.4th percentile), this represents normal volume ; whole brain volume measures 1,105,510 mm³, 7.4% above the reference mean. With a Z-score of 0.92 (82.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,105 mm³, 20.2% below the reference mean. With a Z-score of -1.57 (5.8th percentile), this represents moderate atrophy; fusiform gyrus volume measures 18,268 mm³, 0.3% above the reference mean. With a Z-score of 0.04 (51.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 23,478 mm³, 14.4% above the reference mean. With a Z-score of 1.28 (90.0th percentile), this represents mild enlargement. ",
  "text_data": "Age is 60.1 years. Gender is Female. Education: 19 years. Handedness: Left. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Musculoskeletal; Endocrine-Metabolic; Renal-Genitourinary; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 29.0. MoCA: 26.0. Logical Memory: 8.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.01 SUVR (normal ); Amyloid beta: 1087.00 pg/mL (normal ); Total tau: 113.60 pg/mL (moderate reduced); Phosphorylated tau: 9.02 pg/mL (moderate reduced). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows moderate atrophy (Z-score -1.57, 5.8th percentile), which is concerning for early neurodegeneration, but other key regions (hippocampus, whole brain) are normal or enlarged. Cognitive scores (MMSE 29, MoCA 26) are borderline normal (MoCA slightly below typical cutoff of 26/30), but biomarkers (Aβ normal, reduced tau) and APOE4 negativity argue against typical Alzheimer’s pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (isolated entorhinal atrophy and borderline MoCA suggest early decline, but normal Aβ and conflicting tau levels reduce certainty).",
  "timestamp": "2025-07-26T07:22:52.257844"
}