{
  "ptid_time": "033_S_0734_2017-10-18",
  "img_path": "/data/qiuhui/data/adni/images/033_S_0734/2017-10-18/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 104,594 mm³, 122.5% above the reference mean. With a Z-score of 3.56 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 7,072 mm³, 1.5% above the reference mean. With a Z-score of 0.13 (55.1th percentile), this represents normal volume ; whole brain volume measures 1,080,460 mm³, 5.0% above the reference mean. With a Z-score of 0.65 (74.3th percentile), this represents normal volume ; entorhinal cortex volume measures 5,665 mm³, 42.7% above the reference mean. With a Z-score of 2.80 (99.7th percentile), this represents significant enlargement; fusiform gyrus volume measures 16,559 mm³, 8.3% below the reference mean. With a Z-score of -0.72 (23.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,998 mm³, 0.9% below the reference mean. With a Z-score of -0.08 (46.9th percentile), this represents normal volume . ",
  "text_data": "Age is 83.6 years. Gender is Male. Education: 18 years. MMSE: 28.0. MoCA: 23.0. Logical Memory: 14.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.38 SUVR (significant elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound ventricular enlargement (Z-score 3.56) and significant entorhinal cortex enlargement (Z-score 2.80), which are atypical for normal aging and may suggest neurodegeneration. However, hippocampal volume is normal, and cognitive scores (MMSE 28, MoCA 23) are borderline for MCI but not dementia. The absence of APOE4 and elevated AV45 (amyloid) complicates interpretation.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting imaging markers and borderline cognitive scores)",
  "timestamp": "2025-07-26T05:18:09.014182"
}