{
  "ptid_time": "073_S_4559_2016-06-30",
  "img_path": "/data/qiuhui/data/adni/images/073_S_4559/2016-06-30/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 68,293 mm³, 143.3% above the reference mean. With a Z-score of 3.28 (99.9th percentile), this represents profound enlargement; hippocampal volume measures 5,983 mm³, 15.9% below the reference mean. With a Z-score of -1.46 (7.2th percentile), this represents mild atrophy; whole brain volume measures 991,208 mm³, 1.7% above the reference mean. With a Z-score of 0.21 (58.5th percentile), this represents normal volume ; entorhinal cortex volume measures 3,878 mm³, 5.6% above the reference mean. With a Z-score of 0.34 (63.4th percentile), this represents normal volume ; fusiform gyrus volume measures 17,864 mm³, 5.0% above the reference mean. With a Z-score of 0.46 (67.6th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,384 mm³, 6.3% above the reference mean. With a Z-score of 0.55 (70.9th percentile), this represents normal volume . ",
  "text_data": "Age is 71.4 years. Gender is Female. Education: 20 years. MMSE: 30.0. MoCA: 29.0. Logical Memory: 16.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.05 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The patient shows profound ventricular enlargement (Z-score 3.28) and mild hippocampal atrophy (Z-score -1.46), which are concerning for neurodegenerative changes. However, cognitive testing (MMSE 30, MoCA 29) is intact, and other brain regions (whole brain, entorhinal cortex, fusiform gyrus, middle temporal gyrus) are within normal ranges.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (due to structural changes despite normal cognition)  \n**Confidence:** **Medium** (high structural concern but no cognitive impairment yet; APOE4-negative and normal amyloid further reduce certainty of progression to dementia)",
  "timestamp": "2025-07-26T09:49:57.531378"
}