{
  "ptid_time": "029_S_5166_2013-08-20",
  "img_path": "/data/qiuhui/data/adni/images/029_S_5166/2013-08-20/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 49,369 mm³, 121.0% above the reference mean. With a Z-score of 3.03 (99.9th percentile), this represents profound enlargement; hippocampal volume measures 7,669 mm³, 0.2% below the reference mean. With a Z-score of -0.02 (49.1th percentile), this represents normal volume ; whole brain volume measures 992,760 mm³, 3.5% below the reference mean. With a Z-score of -0.44 (33.0th percentile), this represents normal volume ; entorhinal cortex volume measures 3,508 mm³, 9.9% below the reference mean. With a Z-score of -0.77 (22.2th percentile), this represents normal volume ; fusiform gyrus volume measures 15,214 mm³, 16.5% below the reference mean. With a Z-score of -1.85 (3.2th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 22,959 mm³, 11.9% above the reference mean. With a Z-score of 1.06 (85.5th percentile), this represents mild enlargement. ",
  "text_data": "Age is 65.1 years. Gender is Female. Education: 20 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Endocrine-Metabolic; Gastrointestinal; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 29.0. MoCA: 22.0. Logical Memory: 14.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.98 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound ventricular enlargement (Z-score 3.03) and moderate fusiform gyrus atrophy (Z-score -1.85), while hippocampal and whole brain volumes are within normal ranges. The MMSE is normal (29/30), but the MoCA (22/30) suggests mild cognitive impairment, despite the absence of APOE4 and normal amyloid (AV45).  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting imaging findings—severe ventricular enlargement but preserved hippocampus—and normal amyloid, which is atypical for typical AD progression)",
  "timestamp": "2025-07-26T04:32:42.622915"
}