{
  "ptid_time": "012_S_4128_2011-07-29",
  "img_path": "/data/qiuhui/data/adni/images/012_S_4128/2011-07-29/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 44,859 mm³, 59.8% above the reference mean. With a Z-score of 1.37 (91.5th percentile), this represents mild enlargement; hippocampal volume measures 6,503 mm³, 8.6% below the reference mean. With a Z-score of -0.79 (21.5th percentile), this represents normal volume ; whole brain volume measures 970,132 mm³, 0.5% below the reference mean. With a Z-score of -0.06 (47.7th percentile), this represents normal volume ; entorhinal cortex volume measures 3,371 mm³, 8.2% below the reference mean. With a Z-score of -0.50 (30.7th percentile), this represents normal volume ; fusiform gyrus volume measures 17,480 mm³, 2.7% above the reference mean. With a Z-score of 0.25 (59.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,477 mm³, 12.0% above the reference mean. With a Z-score of 1.05 (85.2th percentile), this represents mild enlargement. ",
  "text_data": "Age is 72.8 years. Gender is Female. Education: 12 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Hematopoietic-Lymphatic; Renal-Genitourinary; Allergies or Drug Sensitivities; Malignancy; Major Surgical Procedures. MMSE: 24.0. MoCA: 21.0. Logical Memory: 7.0. Laboratory findings: Vitamin B12: 996.00 (significant elevated). APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.25 SUVR (mild elevated); Amyloid beta: 879.10 pg/mL (normal ); Total tau: 237.60 pg/mL (normal ); Phosphorylated tau: 22.98 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows mild ventricular enlargement and a slightly reduced hippocampal volume, but most brain regions are within normal ranges. Cognitive testing (MMSE 24, MoCA 21) suggests mild impairment, but CSF biomarkers (Aβ, T-tau, P-tau) are normal, and AV45 (amyloid PET) is only mildly elevated, making Alzheimer's pathology less likely.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely non-amyloid etiology, possibly vascular or other neurodegenerative causes)  \n\n**Confidence:** **Medium** (cognitive scores indicate impairment, but biomarker profile does not strongly support Alzheimer's; structural changes are mild and mixed).",
  "timestamp": "2025-07-25T23:12:24.832564"
}