{
  "ptid_time": "141_S_2333_2017-12-21",
  "img_path": "/data/qiuhui/data/adni/images/141_S_2333/2017-12-21/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 40,648 mm³, 5.5% above the reference mean. With a Z-score of 0.13 (55.3th percentile), this represents normal volume ; hippocampal volume measures 5,993 mm³, 20.7% below the reference mean. With a Z-score of -2.02 (2.2th percentile), this represents significant atrophy; whole brain volume measures 1,030,780 mm³, 4.5% below the reference mean. With a Z-score of -0.58 (27.9th percentile), this represents normal volume ; entorhinal cortex volume measures 3,868 mm³, 5.7% below the reference mean. With a Z-score of -0.38 (35.0th percentile), this represents normal volume ; fusiform gyrus volume measures 19,823 mm³, 5.2% above the reference mean. With a Z-score of 0.45 (67.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,323 mm³, 18.8% below the reference mean. With a Z-score of -1.69 (4.5th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 73.5 years. Gender is Male. Education: 12 years. MMSE: 29.0. MoCA: 25.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.49 SUVR (profound elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows significant atrophy (Z-score -2.02, 2.2nd percentile), and the middle temporal gyrus exhibits moderate atrophy (Z-score -1.69, 4.5th percentile), both of which are strongly associated with Alzheimer's pathology. Despite normal cognitive screening scores (MMSE 29, MoCA 25), the presence of APOE4 and profound AV45 (amyloid PET) positivity supports underlying Alzheimer's pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer’s disease)  \n**Confidence:** **High**  \n\n*(Note: The cognitive scores are still in the normal range, but the biomarker and structural findings strongly suggest early neurodegeneration consistent with MCI due to Alzheimer’s disease.)*",
  "timestamp": "2025-07-26T17:01:02.094094"
}