{
  "ptid_time": "002_S_1261_2017-03-15",
  "img_path": "/data/qiuhui/data/adni/images/002_S_1261/2017-03-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 56,890 mm³, 53.9% above the reference mean. With a Z-score of 1.46 (92.7th percentile), this represents mild enlargement; hippocampal volume measures 5,236 mm³, 19.4% below the reference mean. With a Z-score of -1.55 (6.0th percentile), this represents moderate atrophy; whole brain volume measures 974,119 mm³, 4.9% above the reference mean. With a Z-score of 0.59 (72.4th percentile), this represents normal volume ; entorhinal cortex volume measures 2,946 mm³, 14.9% below the reference mean. With a Z-score of -0.81 (21.0th percentile), this represents normal volume ; fusiform gyrus volume measures 16,259 mm³, 0.9% above the reference mean. With a Z-score of 0.07 (52.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,366 mm³, 1.9% above the reference mean. With a Z-score of 0.17 (56.6th percentile), this represents normal volume . ",
  "text_data": "Age is 81.1 years. Gender is Female. Education: 16 years. MMSE: 30.0. MoCA: 22.0. Logical Memory: 9.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.13 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows moderate hippocampal atrophy (Z-score -1.55, 6th percentile) and mild ventricular enlargement, both suggestive of neurodegeneration. However, cognitive testing is mixed (MMSE 30 normal, MoCA 22 borderline), and amyloid PET (AV45) is normal, making Alzheimer’s pathology less likely.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (structural changes support MCI, but normal amyloid and high MMSE introduce uncertainty).",
  "timestamp": "2025-07-25T20:14:05.634003"
}