{
  "ptid_time": "051_S_6719_2019-05-01",
  "img_path": "/data/qiuhui/data/adni/images/051_S_6719/2019-05-01/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 27,418 mm³, 28.8% below the reference mean. With a Z-score of -0.69 (24.5th percentile), this represents normal volume ; hippocampal volume measures 6,009 mm³, 20.5% below the reference mean. With a Z-score of -2.00 (2.3th percentile), this represents moderate atrophy; whole brain volume measures 1,015,080 mm³, 6.0% below the reference mean. With a Z-score of -0.77 (22.0th percentile), this represents normal volume ; entorhinal cortex volume measures 3,414 mm³, 16.7% below the reference mean. With a Z-score of -1.14 (12.8th percentile), this represents mild atrophy; fusiform gyrus volume measures 17,261 mm³, 8.4% below the reference mean. With a Z-score of -0.71 (23.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,418 mm³, 5.1% above the reference mean. With a Z-score of 0.45 (67.5th percentile), this represents normal volume . ",
  "text_data": "Age is 72.2 years. Gender is Male. Education: 15 years. Handedness: Right. Race: White. MMSE: 28.0. MoCA: 22.0. Logical Memory: 8.0. APOEε4 alleles: 2.0. Biomarker levels: Florbetapir (AV45): 1.22 SUVR (mild elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows moderate atrophy (Z-score -2.00, 2.3rd percentile), which is a strong biomarker for Alzheimer's pathology. The entorhinal cortex also shows mild atrophy, further supporting early neurodegenerative changes. Despite normal MMSE (28), the MoCA (22) suggests mild cognitive impairment, and the presence of two APOE4 alleles increases Alzheimer's risk. AV45 (amyloid PET) being mildly elevated supports amyloid pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer's pathology)  \n**Confidence:** **High** (due to hippocampal atrophy, MoCA score, APOE4 status, and AV45 findings)",
  "timestamp": "2025-07-26T07:38:57.636223"
}