{
  "ptid_time": "941_S_4100_2015-08-28",
  "img_path": "/data/qiuhui/data/adni/images/941_S_4100/2015-08-28/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 68,779 mm³, 86.1% above the reference mean. With a Z-score of 2.32 (99.0th percentile), this represents significant enlargement; hippocampal volume measures 6,734 mm³, 3.7% above the reference mean. With a Z-score of 0.29 (61.6th percentile), this represents normal volume ; whole brain volume measures 1,038,820 mm³, 11.9% above the reference mean. With a Z-score of 1.43 (92.4th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,547 mm³, 2.4% above the reference mean. With a Z-score of 0.13 (55.2th percentile), this represents normal volume ; fusiform gyrus volume measures 19,997 mm³, 24.1% above the reference mean. With a Z-score of 1.81 (96.5th percentile), this represents moderate enlargement; middle temporal gyrus volume measures 21,305 mm³, 18.2% above the reference mean. With a Z-score of 1.62 (94.7th percentile), this represents moderate enlargement. ",
  "text_data": "Age is 82.5 years. Gender is Female. Education: 12 years. MMSE: 25.0. MoCA: 23.0. Logical Memory: 4.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.31 SUVR (moderate elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (Z-score 2.32) and mild-to-moderate enlargement in other brain regions, which is atypical for typical Alzheimer's atrophy patterns. Hippocampal and entorhinal volumes are normal, while cognitive scores (MMSE 25, MoCA 23) are borderline but not strongly indicative of dementia. The absence of APOE4 and moderate AV45 (amyloid) elevation suggests mixed pathology rather than pure Alzheimer’s.  \n\n**Diagnosis:** **MCI** (given borderline cognitive scores and mixed imaging findings, but not meeting full dementia criteria).  \n\n**Confidence:** **Medium** (due to conflicting imaging markers—ventricular enlargement suggests possible non-Alzheimer’s contributions, while cognitive scores are equivocal).",
  "timestamp": "2025-07-26T17:34:43.016410"
}