{
  "ptid_time": "135_S_6411_2020-08-26",
  "img_path": "/data/qiuhui/data/adni/images/135_S_6411/2020-08-26/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 96,376 mm³, 150.2% above the reference mean. With a Z-score of 3.60 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 7,738 mm³, 2.4% above the reference mean. With a Z-score of 0.23 (59.1th percentile), this represents normal volume ; whole brain volume measures 1,245,690 mm³, 15.4% above the reference mean. With a Z-score of 2.00 (97.7th percentile), this represents moderate enlargement; entorhinal cortex volume measures 4,792 mm³, 16.9% above the reference mean. With a Z-score of 1.14 (87.4th percentile), this represents mild enlargement; fusiform gyrus volume measures 19,978 mm³, 6.0% above the reference mean. With a Z-score of 0.52 (69.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,696 mm³, 12.4% below the reference mean. With a Z-score of -1.11 (13.3th percentile), this represents mild atrophy. ",
  "text_data": "Age is 73.4 years. Gender is Male. Education: 20 years. MMSE: 24.0. MoCA: 15.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. Biomarker levels: Flobetaben (FBB): 1.08 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound ventricular enlargement (Z-score 3.60) and mild atrophy in the middle temporal gyrus (Z-score -1.11), while hippocampal volume is normal. Cognitive testing (MMSE 24, MoCA 15) indicates significant impairment, particularly in executive function and attention (MoCA < 26 is concerning). The absence of APOE4 reduces genetic risk but does not rule out neurodegeneration.  \n\n**Diagnosis:** **Dementia** (likely non-Alzheimer's subtype given preserved hippocampal volume but significant cognitive decline and ventricular enlargement).  \n\n**Confidence:** **Medium** (structural changes and cognitive scores strongly suggest dementia, but clinical correlation is needed to rule out other causes like vascular or frontotemporal dementia).",
  "timestamp": "2025-07-26T15:51:23.267935"
}