{
  "ptid_time": "068_S_2187_2019-10-09",
  "img_path": "/data/qiuhui/data/adni/images/068_S_2187/2019-10-09/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 19,368 mm³, 13.3% below the reference mean. With a Z-score of -0.33 (37.0th percentile), this represents normal volume ; hippocampal volume measures 8,297 mm³, 8.0% above the reference mean. With a Z-score of 0.89 (81.4th percentile), this represents normal volume ; whole brain volume measures 1,203,340 mm³, 16.9% above the reference mean. With a Z-score of 2.11 (98.2th percentile), this represents significant enlargement; entorhinal cortex volume measures 3,819 mm³, 1.9% below the reference mean. With a Z-score of -0.15 (44.1th percentile), this represents normal volume ; fusiform gyrus volume measures 20,616 mm³, 13.2% above the reference mean. With a Z-score of 1.49 (93.2th percentile), this represents mild enlargement; middle temporal gyrus volume measures 25,475 mm³, 24.1% above the reference mean. With a Z-score of 2.15 (98.4th percentile), this represents significant enlargement. ",
  "text_data": "Age is 66.7 years. Gender is Female. Education: 13 years. MMSE: 30.0. MoCA: 25.0. Logical Memory: 16.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.01 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements show normal or above-normal volumes in all regions, including the hippocampus and entorhinal cortex, which are typically affected in Alzheimer's. The MMSE score of 30 is perfect, but the MoCA score of 25 suggests mild cognitive inefficiency, possibly due to non-neurodegenerative factors (e.g., mood, sleep, or vascular issues). APOE4 carrier status increases Alzheimer's risk, but the normal AV45 (amyloid PET) and preserved brain volumes argue against active neurodegeneration.  \n\n**Diagnosis:** **CN (Cognitively Normal)** with possible non-Alzheimer's contributors to the slightly reduced MoCA.  \n\n**Confidence:** **Medium** (due to the discrepancy between MMSE and MoCA, but strong structural and biomarker evidence against MCI/dementia).",
  "timestamp": "2025-07-26T08:55:38.145407"
}