{
  "ptid_time": "073_S_4559_2014-03-20",
  "img_path": "/data/qiuhui/data/adni/images/073_S_4559/2014-03-20/t1.nii.gz",
  "img_finding": "Image findings: hippocampal volume measures 6,339 mm³, 17.5% below the reference mean. With a Z-score of -1.97 (2.5th percentile), this represents moderate atrophy; whole brain volume measures 999,960 mm³, 2.8% below the reference mean. With a Z-score of -0.35 (36.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,833 mm³, 1.5% below the reference mean. With a Z-score of -0.12 (45.3th percentile), this represents normal volume ; fusiform gyrus volume measures 18,221 mm³, 0.1% above the reference mean. With a Z-score of 0.01 (50.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,192 mm³, 3.3% above the reference mean. With a Z-score of 0.29 (61.5th percentile), this represents normal volume . ",
  "text_data": "Age is 69.4 years. Gender is Female. Education: 20 years. MMSE: 30.0. MoCA: 25.0. Logical Memory: 19.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.08 SUVR (normal ); Total tau: 198.50 pg/mL (normal ); Phosphorylated tau: 17.06 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows moderate atrophy (Z-score -1.97, 2.5th percentile), which is concerning for early neurodegenerative changes, while other brain regions are within normal limits. Cognitive testing shows a normal MMSE but borderline MoCA (25/30), suggesting possible subtle cognitive impairment. Biomarkers (T-tau, P-tau, AV45) are normal, and there is no APOE4 risk allele.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Hippocampal atrophy supports MCI, but normal biomarkers and borderline MoCA introduce some uncertainty.)",
  "timestamp": "2025-07-26T09:49:48.604191"
}