{
  "ptid_time": "019_S_4835_2016-06-27",
  "img_path": "/data/qiuhui/data/adni/images/019_S_4835/2016-06-27/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 44,116 mm³, 6.2% below the reference mean. With a Z-score of -0.18 (42.9th percentile), this represents normal volume ; hippocampal volume measures 8,634 mm³, 23.9% above the reference mean. With a Z-score of 2.07 (98.1th percentile), this represents significant enlargement; whole brain volume measures 1,157,920 mm³, 12.5% above the reference mean. With a Z-score of 1.64 (94.9th percentile), this represents moderate enlargement; entorhinal cortex volume measures 4,856 mm³, 22.3% above the reference mean. With a Z-score of 1.46 (92.8th percentile), this represents mild enlargement; fusiform gyrus volume measures 20,050 mm³, 11.0% above the reference mean. With a Z-score of 0.95 (82.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 23,688 mm³, 17.4% above the reference mean. With a Z-score of 1.56 (94.1th percentile), this represents moderate enlargement. ",
  "text_data": "Age is 83.3 years. Gender is Male. Education: 16 years. MMSE: 28.0. MoCA: 22.0. Logical Memory: 11.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.19 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows significant enlargement in the hippocampus and mild-to-moderate enlargement in other regions, which is atypical for Alzheimer's disease (AD). The MMSE is normal (28/30), but the MoCA (22/30) suggests mild cognitive impairment (MCI). The absence of APOE4 and normal AV45 (amyloid PET) further reduces the likelihood of AD.  \n\n**Diagnosis:** **MCI** (likely non-amnesic or non-AD etiology given preserved hippocampal volume and normal amyloid)  \n**Confidence:** **Medium** (MoCA supports MCI, but atypical volumetric findings and normal amyloid complicate the diagnosis)",
  "timestamp": "2025-07-26T01:08:47.533349"
}