{
  "ptid_time": "005_S_0610_2012-11-13",
  "img_path": "/data/qiuhui/data/adni/images/005_S_0610/2012-11-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 59,477 mm³, 26.5% above the reference mean. With a Z-score of 0.77 (77.9th percentile), this represents normal volume ; hippocampal volume measures 5,643 mm³, 19.0% below the reference mean. With a Z-score of -1.64 (5.0th percentile), this represents moderate atrophy; whole brain volume measures 853,906 mm³, 17.0% below the reference mean. With a Z-score of -2.23 (1.3th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,980 mm³, 24.9% below the reference mean. With a Z-score of -1.63 (5.1th percentile), this represents moderate atrophy; fusiform gyrus volume measures 12,559 mm³, 30.5% below the reference mean. With a Z-score of -2.64 (0.4th percentile), this represents significant atrophy; middle temporal gyrus volume measures 17,055 mm³, 15.5% below the reference mean. With a Z-score of -1.39 (8.3th percentile), this represents mild atrophy. ",
  "text_data": "Age is 85.0 years. Gender is Male. Education: 20 years. MMSE: 30.0. MoCA: 25.0. Logical Memory: 17.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.98 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in whole brain volume and fusiform gyrus, along with moderate atrophy in the hippocampus and entorhinal cortex—key regions affected in Alzheimer’s disease. However, cognitive scores (MMSE 30, MoCA 25) are largely intact, suggesting preserved function despite structural changes.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely amnestic subtype given hippocampal/entorhinal atrophy, but without clear functional decline).  \n\n**Confidence:** **Medium** (imaging strongly suggests neurodegeneration, but high MMSE and normal AV45 complicate a dementia diagnosis; clinical correlation needed).  \n\n*Note:* APOE4-negative status and normal AV45 (amyloid PET) reduce likelihood of typical Alzheimer’s pathology, but other etiologies (e.g., primary age-related tauopathy [PART], vascular contributions) could explain the atrophy. Follow-up with CSF biomarkers or tau PET may clarify.",
  "timestamp": "2025-07-25T21:15:09.924714"
}