{
  "ptid_time": "029_S_2376_2011-07-01",
  "img_path": "/data/qiuhui/data/adni/images/029_S_2376/2011-07-01/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 74,527 mm³, 58.5% above the reference mean. With a Z-score of 1.70 (95.5th percentile), this represents moderate enlargement; hippocampal volume measures 6,133 mm³, 12.0% below the reference mean. With a Z-score of -1.04 (15.0th percentile), this represents mild atrophy; whole brain volume measures 1,171,640 mm³, 13.8% above the reference mean. With a Z-score of 1.81 (96.5th percentile), this represents moderate enlargement; entorhinal cortex volume measures 4,756 mm³, 19.8% above the reference mean. With a Z-score of 1.30 (90.3th percentile), this represents mild enlargement; fusiform gyrus volume measures 26,192 mm³, 45.0% above the reference mean. With a Z-score of 3.89 (100.0th percentile), this represents profound enlargement; middle temporal gyrus volume measures 22,177 mm³, 9.9% above the reference mean. With a Z-score of 0.89 (81.4th percentile), this represents normal volume . ",
  "text_data": "Age is 81.9 years. Gender is Male. Education: 17 years. MMSE: 28.0. MoCA: 25.0. Logical Memory: 11.0. Laboratory findings: Hematocrit: 49.00 (significant elevated); Hemoglobin: 16.90 (significant elevated); Total Bilirubin: 0.90 (significant elevated); Total Protein: 6.20 (significant reduced); Creatine Kinase: 277.00 (profound elevated). APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.34 SUVR (significant elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows moderate ventricular enlargement and mild hippocampal atrophy, which are concerning for neurodegenerative changes, but the whole brain, entorhinal cortex, fusiform gyrus, and middle temporal gyrus volumes are normal or enlarged, which is atypical for Alzheimer’s. The MMSE (28) and MoCA (25) scores are near-normal, suggesting preserved cognition despite imaging findings. The elevated AV45 (amyloid PET) and APOE4 positivity increase Alzheimer’s risk, but the lack of significant cognitive impairment complicates the diagnosis.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Cognitive scores are strong, but imaging and biomarker data suggest early pathology; clinical correlation is needed to confirm progression.)",
  "timestamp": "2025-07-26T04:25:12.113631"
}