{
  "ptid_time": "022_S_2379_2015-08-14",
  "img_path": "/data/qiuhui/data/adni/images/022_S_2379/2015-08-14/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 21,708 mm³, 43.6% below the reference mean. With a Z-score of -1.05 (14.8th percentile), this represents mild atrophy; hippocampal volume measures 9,753 mm³, 29.0% above the reference mean. With a Z-score of 2.83 (99.8th percentile), this represents significant enlargement; whole brain volume measures 1,167,090 mm³, 8.1% above the reference mean. With a Z-score of 1.05 (85.4th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,626 mm³, 11.6% below the reference mean. With a Z-score of -0.78 (21.6th percentile), this represents normal volume ; fusiform gyrus volume measures 23,663 mm³, 25.6% above the reference mean. With a Z-score of 2.18 (98.5th percentile), this represents significant enlargement; middle temporal gyrus volume measures 22,324 mm³, 4.6% above the reference mean. With a Z-score of 0.41 (66.1th percentile), this represents normal volume . ",
  "text_data": "Age is 70.0 years. Gender is Male. Education: 18 years. MMSE: 29.0. MoCA: 24.0. Logical Memory: 16.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.07 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows mixed findings, with mild ventricular atrophy but significant hippocampal and fusiform gyrus enlargement, which is atypical for Alzheimer's disease. Cognitive scores (MMSE 29, MoCA 24) are borderline for MCI but not strongly indicative of dementia. The absence of APOE4 and normal AV45 (amyloid PET) further reduce the likelihood of Alzheimer's pathology.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to conflicting imaging findings and borderline MoCA score)",
  "timestamp": "2025-07-26T02:16:29.853746"
}