{
  "ptid_time": "137_S_4536_2019-11-15",
  "img_path": "/data/qiuhui/data/adni/images/137_S_4536/2019-11-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 48,090 mm³, 30.1% above the reference mean. With a Z-score of 0.81 (79.2th percentile), this represents normal volume ; hippocampal volume measures 5,297 mm³, 18.4% below the reference mean. With a Z-score of -1.48 (7.0th percentile), this represents mild atrophy; whole brain volume measures 959,681 mm³, 3.4% above the reference mean. With a Z-score of 0.41 (65.8th percentile), this represents normal volume ; entorhinal cortex volume measures 3,273 mm³, 5.5% below the reference mean. With a Z-score of -0.30 (38.4th percentile), this represents normal volume ; fusiform gyrus volume measures 18,839 mm³, 16.9% above the reference mean. With a Z-score of 1.27 (89.9th percentile), this represents mild enlargement; middle temporal gyrus volume measures 17,830 mm³, 1.1% below the reference mean. With a Z-score of -0.10 (46.1th percentile), this represents normal volume . ",
  "text_data": "Age is 85.4 years. Gender is Female. Education: 17 years. MMSE: 19.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.10 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.48, 7th percentile), which is concerning for neurodegeneration, while other brain regions are largely normal. The MMSE score of 19 suggests cognitive impairment, but the absence of APOE4 and normal AV45 (amyloid PET) reduces the likelihood of Alzheimer's pathology.  \n**Diagnosis:** **MCI** (given hippocampal atrophy and cognitive decline, but not severe enough for dementia and no clear Alzheimer's biomarkers).  \n**Confidence:** **Medium** (hippocampal atrophy supports MCI, but the lack of amyloid positivity introduces uncertainty about the underlying cause).",
  "timestamp": "2025-07-26T16:36:17.347114"
}