{
  "ptid_time": "053_S_2396_2013-07-26",
  "img_path": "/data/qiuhui/data/adni/images/053_S_2396/2013-07-26/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 47,940 mm³, 70.8% above the reference mean. With a Z-score of 1.62 (94.8th percentile), this represents moderate enlargement; hippocampal volume measures 8,458 mm³, 18.9% above the reference mean. With a Z-score of 1.73 (95.8th percentile), this represents moderate enlargement; whole brain volume measures 1,017,960 mm³, 4.4% above the reference mean. With a Z-score of 0.56 (71.2th percentile), this represents normal volume . ",
  "text_data": "Age is 72.2 years. Gender is Female. Education: 14 years. MMSE: 28.0. MoCA: 23.0. Logical Memory: 6.0. APOEε4 alleles: 0.0. Biomarker levels: Total tau: 214.20 pg/mL (normal ); Phosphorylated tau: 19.61 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows moderate ventricular enlargement (Z-score 1.62) and hippocampal enlargement (Z-score 1.73), which are atypical for Alzheimer's but may suggest other neurodegenerative processes. Cognitive testing (MMSE 28, MoCA 23) indicates mild cognitive impairment (MCI), while normal CSF biomarkers (T-tau, P-tau) and absence of APOE4 reduce Alzheimer's likelihood.  \n\n**Diagnosis:** **MCI** (likely non-Alzheimer's etiology)  \n**Confidence:** **Medium** (due to conflicting imaging findings and normal biomarkers)",
  "timestamp": "2025-07-26T07:58:18.465081"
}