{
  "ptid_time": "126_S_4891_2014-08-13",
  "img_path": "/data/qiuhui/data/adni/images/126_S_4891/2014-08-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 33,910 mm³, 12.9% above the reference mean. With a Z-score of 0.31 (62.1th percentile), this represents normal volume ; hippocampal volume measures 8,459 mm³, 5.4% above the reference mean. With a Z-score of 0.54 (70.5th percentile), this represents normal volume ; whole brain volume measures 1,218,660 mm³, 7.4% above the reference mean. With a Z-score of 1.05 (85.3th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,736 mm³, 12.4% below the reference mean. With a Z-score of -0.86 (19.6th percentile), this represents normal volume ; fusiform gyrus volume measures 25,649 mm³, 28.8% above the reference mean. With a Z-score of 2.40 (99.2th percentile), this represents significant enlargement; middle temporal gyrus volume measures 25,215 mm³, 12.5% above the reference mean. With a Z-score of 1.03 (84.9th percentile), this represents mild enlargement. ",
  "text_data": "Age is 61.7 years. Gender is Male. Education: 15 years. MMSE: 28.0. MoCA: 24.0. Logical Memory: 11.0. APOEε4 alleles: 2.0. Biomarker levels: Florbetapir (AV45): 1.56 SUVR (profound elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows normal to mildly enlarged volumes in most regions, with the exception of the entorhinal cortex, which is slightly below the reference mean but still within the normal range (Z-score -0.86). The MMSE score of 28 is within the normal range, but the MoCA score of 24 suggests mild cognitive impairment (MCI). The presence of two APOE4 alleles and profoundly elevated AV45 (amyloid PET) strongly indicates amyloid pathology, increasing the risk for Alzheimer's disease (AD).  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer's pathology)  \n**Confidence:** **High** (due to amyloid positivity, APOE4 homozygosity, and borderline MoCA score despite normal MMSE)",
  "timestamp": "2025-07-26T12:50:51.448628"
}