{
  "ptid_time": "129_S_6848_2020-01-24",
  "img_path": "/data/qiuhui/data/adni/images/129_S_6848/2020-01-24/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 87,679 mm³, 192.0% above the reference mean. With a Z-score of 4.56 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 5,828 mm³, 27.4% below the reference mean. With a Z-score of -2.74 (0.3th percentile), this represents significant atrophy; whole brain volume measures 1,185,870 mm³, 4.5% above the reference mean. With a Z-score of 0.64 (73.9th percentile), this represents normal volume ; entorhinal cortex volume measures 2,504 mm³, 41.3% below the reference mean. With a Z-score of -2.86 (0.2th percentile), this represents significant atrophy; fusiform gyrus volume measures 22,574 mm³, 13.4% above the reference mean. With a Z-score of 1.11 (86.7th percentile), this represents mild enlargement; middle temporal gyrus volume measures 25,569 mm³, 14.1% above the reference mean. With a Z-score of 1.16 (87.7th percentile), this represents mild enlargement. ",
  "text_data": "Age is 63.0 years. Gender is Male. Education: 15 years. Handedness: Left. Race: White. MMSE: 30.0. MoCA: 25.0. Logical Memory: 8.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.94 SUVR (mild reduced). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant hippocampal and entorhinal cortex atrophy, which are hallmark features of Alzheimer's disease, alongside profound ventricular enlargement (often seen in neurodegeneration). However, cognitive scores (MMSE 30, MoCA 25) are near-normal, suggesting preserved function despite structural changes. The absence of APOE4 and only mild amyloid burden (AV45) complicates the picture.  \n**Diagnosis:** **MCI** (structural changes are severe, but cognitive impairment is not yet dementia-level).  \n**Confidence:** **Medium** (discrepancy between imaging and clinical scores raises questions about progression speed or compensatory mechanisms).",
  "timestamp": "2025-07-26T14:21:35.900682"
}