{
  "ptid_time": "098_S_2079_2016-12-08",
  "img_path": "/data/qiuhui/data/adni/images/098_S_2079/2016-12-08/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 38,271 mm³, 0.6% below the reference mean. With a Z-score of -0.02 (49.4th percentile), this represents normal volume ; hippocampal volume measures 6,642 mm³, 12.1% below the reference mean. With a Z-score of -1.18 (11.8th percentile), this represents mild atrophy; whole brain volume measures 1,172,370 mm³, 8.6% above the reference mean. With a Z-score of 1.12 (86.8th percentile), this represents mild enlargement; entorhinal cortex volume measures 4,510 mm³, 10.0% above the reference mean. With a Z-score of 0.68 (75.1th percentile), this represents normal volume ; fusiform gyrus volume measures 19,881 mm³, 5.5% above the reference mean. With a Z-score of 0.47 (68.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 24,818 mm³, 16.3% above the reference mean. With a Z-score of 1.47 (92.9th percentile), this represents mild enlargement. ",
  "text_data": "Age is 71.5 years. Gender is Male. Education: 13 years. MMSE: 26.0. MoCA: 20.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.51 SUVR (profound elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.18, 11.8th percentile), which is concerning for early neurodegenerative changes, while other brain regions are normal or mildly enlarged. The MoCA score of 20 suggests cognitive impairment, but the MMSE of 26 is borderline normal. The absence of APOE4 reduces genetic risk, but the profoundly elevated AV45 (amyloid PET) strongly supports Alzheimer’s pathology.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**",
  "timestamp": "2025-07-26T10:45:05.972541"
}