{
  "ptid_time": "128_S_2220_2013-02-07",
  "img_path": "/data/qiuhui/data/adni/images/128_S_2220/2013-02-07/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 44,314 mm³, 5.7% below the reference mean. With a Z-score of -0.17 (43.4th percentile), this represents normal volume ; hippocampal volume measures 5,985 mm³, 14.1% below the reference mean. With a Z-score of -1.22 (11.1th percentile), this represents mild atrophy; whole brain volume measures 1,036,090 mm³, 0.7% above the reference mean. With a Z-score of 0.09 (53.5th percentile), this represents normal volume ; entorhinal cortex volume measures 4,876 mm³, 22.9% above the reference mean. With a Z-score of 1.50 (93.3th percentile), this represents mild enlargement; fusiform gyrus volume measures 17,258 mm³, 4.5% below the reference mean. With a Z-score of -0.39 (34.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,718 mm³, 7.7% above the reference mean. With a Z-score of 0.69 (75.4th percentile), this represents normal volume . ",
  "text_data": "Age is 84.0 years. Gender is Male. Education: 20 years. MMSE: 29.0. MoCA: 29.0. Logical Memory: 12.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.93 SUVR (mild reduced). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.22, 11.1th percentile), which is a key biomarker for Alzheimer's pathology, but other brain volumes are largely normal or even enlarged (e.g., entorhinal cortex). Cognitive scores (MMSE 29, MoCA 29) are intact, and there is no APOE4 risk allele. AV45 (amyloid PET) shows only mild reduction, not strongly indicative of amyloid burden.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (Hippocampal atrophy is concerning, but preserved cognition and lack of strong amyloid signal suggest no current dementia or MCI. Age-related changes may contribute.)",
  "timestamp": "2025-07-26T14:00:51.995834"
}