{
  "ptid_time": "082_S_2121_2018-02-12",
  "img_path": "/data/qiuhui/data/adni/images/082_S_2121/2018-02-12/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 33,429 mm³, 19.1% above the reference mean. With a Z-score of 0.44 (66.9th percentile), this represents normal volume ; hippocampal volume measures 6,297 mm³, 11.5% below the reference mean. With a Z-score of -1.05 (14.6th percentile), this represents mild atrophy; whole brain volume measures 1,058,760 mm³, 8.6% above the reference mean. With a Z-score of 1.09 (86.1th percentile), this represents mild enlargement; entorhinal cortex volume measures 4,000 mm³, 8.9% above the reference mean. With a Z-score of 0.55 (70.8th percentile), this represents normal volume ; fusiform gyrus volume measures 20,878 mm³, 22.7% above the reference mean. With a Z-score of 2.07 (98.1th percentile), this represents significant enlargement; middle temporal gyrus volume measures 21,006 mm³, 9.6% above the reference mean. With a Z-score of 0.83 (79.7th percentile), this represents normal volume . ",
  "text_data": "Age is 75.3 years. Gender is Female. Education: 14 years. MMSE: 29.0. MoCA: 23.0. Logical Memory: 13.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.44 SUVR (significant elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.05, 14.6th percentile), which is concerning for early neurodegenerative changes, while other regions (ventricular, whole brain, entorhinal cortex, fusiform gyrus, middle temporal gyrus) are normal or enlarged. The MoCA score of 23 suggests mild cognitive impairment, supported by elevated AV45 (amyloid positivity) and APOE4 carrier status.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Hippocampal atrophy and amyloid positivity suggest early neurodegeneration, but preserved MMSE and some enlarged brain volumes complicate the picture.)",
  "timestamp": "2025-07-26T10:03:52.215235"
}