{
  "ptid_time": "014_S_2308_2011-05-19",
  "img_path": "/data/qiuhui/data/adni/images/014_S_2308/2011-05-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 40,283 mm³, 4.6% above the reference mean. With a Z-score of 0.11 (54.4th percentile), this represents normal volume ; hippocampal volume measures 6,695 mm³, 11.4% below the reference mean. With a Z-score of -1.12 (13.2th percentile), this represents mild atrophy; whole brain volume measures 903,094 mm³, 16.3% below the reference mean. With a Z-score of -2.12 (1.7th percentile), this represents significant atrophy. ",
  "text_data": "Age is 74.8 years. Gender is Male. Education: 15 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Hepatic; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 29.0. MoCA: 24.0. Logical Memory: 11.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.99 SUVR (normal ); Amyloid beta: 982.60 pg/mL (normal ); Total tau: 142.00 pg/mL (mild reduced); Phosphorylated tau: 11.78 pg/mL (mild reduced). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "Reasoning: The hippocampal and whole brain volumes show mild to significant atrophy, which is concerning for neurodegenerative changes. However, cognitive scores (MMSE 29, MoCA 24) are borderline normal to mildly impaired, and biomarkers (Aβ normal, tau reduced) do not strongly support Alzheimer's pathology.  \nDiagnosis: **MCI** (Mild Cognitive Impairment)  \nConfidence: **Medium** (due to conflicting imaging and biomarker findings despite cognitive scores suggesting mild impairment)",
  "timestamp": "2025-07-25T23:48:31.812371"
}