{
  "ptid_time": "027_S_4873_2014-08-14",
  "img_path": "/data/qiuhui/data/adni/images/027_S_4873/2014-08-14/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 54,467 mm³, 15.8% above the reference mean. With a Z-score of 0.46 (67.7th percentile), this represents normal volume ; hippocampal volume measures 5,273 mm³, 24.3% below the reference mean. With a Z-score of -2.10 (1.8th percentile), this represents significant atrophy; whole brain volume measures 1,064,160 mm³, 3.4% above the reference mean. With a Z-score of 0.45 (67.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,162 mm³, 20.3% below the reference mean. With a Z-score of -1.33 (9.2th percentile), this represents mild atrophy; fusiform gyrus volume measures 18,276 mm³, 1.2% above the reference mean. With a Z-score of 0.10 (54.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,300 mm³, 4.3% below the reference mean. With a Z-score of -0.39 (34.9th percentile), this represents normal volume . ",
  "text_data": "Age is 84.6 years. Gender is Male. Education: 12 years. MMSE: 22.0. MoCA: 17.0. Logical Memory: 2.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.97 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant hippocampal atrophy (Z-score -2.10, 1.8th percentile) and mild entorhinal cortex atrophy (Z-score -1.33, 9.2th percentile), both key regions in Alzheimer's pathology. Cognitive testing (MMSE 22, MoCA 17) indicates impairment, but the absence of APOE4 and normal AV45 (amyloid PET) suggests non-Alzheimer’s neurodegeneration or mixed pathology.  \n\n**Diagnosis:** **Dementia** (likely non-amyloid etiology, such as hippocampal sclerosis or primary age-related tauopathy)  \n**Confidence:** **Medium** (due to conflicting biomarkers—severe atrophy but normal amyloid)",
  "timestamp": "2025-07-26T04:00:42.772055"
}