{
  "ptid_time": "072_S_4103_2013-08-19",
  "img_path": "/data/qiuhui/data/adni/images/072_S_4103/2013-08-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 33,335 mm³, 13.5% below the reference mean. With a Z-score of -0.32 (37.4th percentile), this represents normal volume ; hippocampal volume measures 5,650 mm³, 25.3% below the reference mean. With a Z-score of -2.46 (0.7th percentile), this represents significant atrophy; whole brain volume measures 835,365 mm³, 22.6% below the reference mean. With a Z-score of -2.93 (0.2th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,787 mm³, 32.0% below the reference mean. With a Z-score of -2.17 (1.5th percentile), this represents significant atrophy; fusiform gyrus volume measures 15,818 mm³, 16.0% below the reference mean. With a Z-score of -1.37 (8.6th percentile), this represents mild atrophy; middle temporal gyrus volume measures 15,461 mm³, 27.5% below the reference mean. With a Z-score of -2.48 (0.7th percentile), this represents significant atrophy. ",
  "text_data": "Age is 72.9 years. Gender is Male. Education: 20 years. MMSE: 30.0. MoCA: 23.0. Logical Memory: 12.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.01 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in key Alzheimer's-related regions (hippocampus, entorhinal cortex, middle temporal gyrus, and whole brain), despite normal ventricular volume. The MoCA score of 23 suggests mild cognitive impairment, while the MMSE of 30 is less sensitive. The absence of APOE4 and normal AV45 (amyloid PET) lowers Alzheimer’s likelihood but does not rule out neurodegeneration.  \n\n**Diagnosis:** **MCI** (likely non-amyloid etiology, e.g., hippocampal sclerosis or primary age-related tauopathy)  \n**Confidence:** **Medium** (structural atrophy and MoCA support MCI, but atypical biomarker profile warrants caution).",
  "timestamp": "2025-07-26T09:17:43.152983"
}