{
  "ptid_time": "168_S_6321_2020-10-21",
  "img_path": "/data/qiuhui/data/adni/images/168_S_6321/2020-10-21/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 101,700 mm³, 164.0% above the reference mean. With a Z-score of 3.93 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 7,265 mm³, 3.9% below the reference mean. With a Z-score of -0.38 (35.2th percentile), this represents normal volume ; whole brain volume measures 1,081,110 mm³, 0.2% above the reference mean. With a Z-score of 0.02 (50.8th percentile), this represents normal volume ; entorhinal cortex volume measures 3,913 mm³, 4.6% below the reference mean. With a Z-score of -0.31 (37.8th percentile), this represents normal volume ; fusiform gyrus volume measures 16,494 mm³, 12.4% below the reference mean. With a Z-score of -1.06 (14.5th percentile), this represents mild atrophy; middle temporal gyrus volume measures 19,013 mm³, 10.9% below the reference mean. With a Z-score of -0.98 (16.4th percentile), this represents normal volume . ",
  "text_data": "Age is 75.3 years. Gender is Male. Education: 20 years. MMSE: 29.0. MoCA: 24.0. Logical Memory: 13.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.98 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound ventricular enlargement (Z-score 3.93), which is strongly suggestive of neurodegeneration, but hippocampal and whole brain volumes are within normal ranges. The MMSE (29) is normal, but the MoCA (24) suggests mild cognitive impairment. The fusiform gyrus shows mild atrophy, but other regions are largely unaffected. Given the normal AV45 (amyloid PET) and no APOE4 risk allele, Alzheimer's pathology is less likely.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting imaging and cognitive findings, with ventricular enlargement being the most concerning feature)",
  "timestamp": "2025-07-26T17:20:02.164622"
}