{
  "ptid_time": "016_S_2007_2010-06-17",
  "img_path": "/data/qiuhui/data/adni/images/016_S_2007/2010-06-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 88,181 mm³, 138.6% above the reference mean. With a Z-score of 3.74 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 5,614 mm³, 13.6% below the reference mean. With a Z-score of -1.09 (13.9th percentile), this represents mild atrophy; whole brain volume measures 920,710 mm³, 0.8% below the reference mean. With a Z-score of -0.10 (46.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,352 mm³, 3.2% below the reference mean. With a Z-score of -0.17 (43.2th percentile), this represents normal volume ; fusiform gyrus volume measures 18,157 mm³, 12.7% above the reference mean. With a Z-score of 0.96 (83.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,567 mm³, 14.1% above the reference mean. With a Z-score of 1.25 (89.5th percentile), this represents mild enlargement. ",
  "text_data": "Age is 83.4 years. Gender is Female. Education: 20 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 29.0. MoCA: 23.0. Logical Memory: 10.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.45 SUVR (significant elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound ventricular enlargement (Z-score 3.74) and mild hippocampal atrophy (Z-score -1.09), which are concerning for neurodegenerative changes. However, cognitive testing (MMSE 29, MoCA 23) suggests only mild cognitive impairment (MCI), not full dementia, and the absence of APOE4 and normal whole brain/entorhinal volumes argue against rapid progression.  \n\n**Diagnosis:** **MCI** (Mild Cognitive Impairment)  \n**Confidence:** **Medium** (due to conflicting findings—severe ventricular enlargement but relatively preserved cognition and no APOE4 risk)",
  "timestamp": "2025-07-26T00:22:06.504431"
}