{
  "ptid_time": "032_S_2119_2017-06-16",
  "img_path": "/data/qiuhui/data/adni/images/032_S_2119/2017-06-16/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 53,530 mm³, 39.0% above the reference mean. With a Z-score of 0.93 (82.5th percentile), this represents normal volume ; hippocampal volume measures 6,088 mm³, 19.5% below the reference mean. With a Z-score of -1.90 (2.9th percentile), this represents moderate atrophy; whole brain volume measures 1,044,390 mm³, 3.2% below the reference mean. With a Z-score of -0.42 (33.7th percentile), this represents normal volume ; entorhinal cortex volume measures 4,469 mm³, 9.0% above the reference mean. With a Z-score of 0.61 (72.9th percentile), this represents normal volume ; fusiform gyrus volume measures 19,859 mm³, 5.4% above the reference mean. With a Z-score of 0.46 (67.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,498 mm³, 3.9% below the reference mean. With a Z-score of -0.35 (36.2th percentile), this represents normal volume . ",
  "text_data": "Age is 78.2 years. Gender is Male. Education: 12 years. MMSE: 27.0. MoCA: 20.0. Logical Memory: 10.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.01 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows moderate atrophy (Z-score -1.90, 2.9th percentile), which is a strong biomarker for Alzheimer's pathology. The MMSE score of 27 is within normal limits, but the MoCA score of 20 suggests mild cognitive impairment (MCI). The absence of APOE4 and normal AV45 (amyloid PET) reduces the likelihood of Alzheimer's but does not rule out other neurodegenerative causes.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting biomarkers—hippocampal atrophy suggests neurodegeneration, but normal amyloid and APOE4 status complicate the diagnosis)",
  "timestamp": "2025-07-26T05:02:19.007524"
}