{
  "ptid_time": "072_S_4391_2014-01-14",
  "img_path": "/data/qiuhui/data/adni/images/072_S_4391/2014-01-14/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 26,686 mm³, 30.7% below the reference mean. With a Z-score of -0.74 (23.1th percentile), this represents normal volume ; hippocampal volume measures 6,460 mm³, 14.5% below the reference mean. With a Z-score of -1.42 (7.8th percentile), this represents mild atrophy; whole brain volume measures 921,948 mm³, 14.6% below the reference mean. With a Z-score of -1.89 (2.9th percentile), this represents moderate atrophy; entorhinal cortex volume measures 3,700 mm³, 9.8% below the reference mean. With a Z-score of -0.66 (25.4th percentile), this represents normal volume ; fusiform gyrus volume measures 16,228 mm³, 13.9% below the reference mean. With a Z-score of -1.18 (11.9th percentile), this represents mild atrophy; middle temporal gyrus volume measures 17,150 mm³, 19.6% below the reference mean. With a Z-score of -1.76 (3.9th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 76.4 years. Gender is Male. Education: 12 years. MMSE: 29.0. MoCA: 29.0. Logical Memory: 12.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.01 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows mild to moderate atrophy in the hippocampus, whole brain, fusiform gyrus, and middle temporal gyrus, which are regions commonly affected in Alzheimer's disease. However, cognitive scores (MMSE, MoCA) are intact, and amyloid PET (AV45) is normal, suggesting no significant functional impairment or amyloid pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (structural changes without overt cognitive decline or amyloid positivity).  \n\n**Confidence:** **Medium** (due to conflicting evidence—structural atrophy but normal cognition and amyloid status).",
  "timestamp": "2025-07-26T09:21:26.512879"
}