{
  "ptid_time": "013_S_5137_2013-04-19",
  "img_path": "/data/qiuhui/data/adni/images/013_S_5137/2013-04-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 69,867 mm³, 148.9% above the reference mean. With a Z-score of 3.41 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 7,196 mm³, 1.1% above the reference mean. With a Z-score of 0.11 (54.2th percentile), this represents normal volume ; whole brain volume measures 997,228 mm³, 2.3% above the reference mean. With a Z-score of 0.29 (61.5th percentile), this represents normal volume ; entorhinal cortex volume measures 4,509 mm³, 22.8% above the reference mean. With a Z-score of 1.40 (91.9th percentile), this represents mild enlargement; fusiform gyrus volume measures 15,360 mm³, 9.7% below the reference mean. With a Z-score of -0.88 (18.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,775 mm³, 2.1% below the reference mean. With a Z-score of -0.18 (42.9th percentile), this represents normal volume . ",
  "text_data": "Age is 78.9 years. Gender is Female. Education: 19 years. Handedness: Right. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Musculoskeletal; Hematopoietic-Lymphatic; Allergies or Drug Sensitivities; Malignancy; Major Surgical Procedures. MMSE: 29.0. MoCA: 26.0. Logical Memory: 11.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.01 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound ventricular enlargement (Z-score 3.41), which is a strong indicator of neurodegeneration, but hippocampal volume is normal (Z-score 0.11), and whole brain volume is also within normal limits (Z-score 0.29). Cognitive scores (MMSE 29, MoCA 26) are borderline for MCI but still relatively preserved. The absence of APOE4 and normal AV45 (amyloid PET) reduces the likelihood of Alzheimer’s pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting markers—ventricular enlargement suggests neurodegeneration, but cognitive scores and other volumes are near-normal)",
  "timestamp": "2025-07-25T23:37:13.481683"
}