{
  "ptid_time": "137_S_1414_2012-08-21",
  "img_path": "/data/qiuhui/data/adni/images/137_S_1414/2012-08-21/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 31,806 mm³, 17.4% below the reference mean. With a Z-score of -0.42 (33.8th percentile), this represents normal volume ; hippocampal volume measures 6,080 mm³, 19.6% below the reference mean. With a Z-score of -1.91 (2.8th percentile), this represents moderate atrophy; whole brain volume measures 1,032,990 mm³, 4.3% below the reference mean. With a Z-score of -0.56 (28.8th percentile), this represents normal volume . ",
  "text_data": "Age is 79.3 years. Gender is Male. Education: 18 years. MMSE: 27.0. MoCA: 20.0. Logical Memory: 5.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.16 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows moderate atrophy (Z-score -1.91, 2.8th percentile), which is a strong biomarker for Alzheimer's pathology, while ventricular and whole brain volumes are within normal ranges. The MoCA score of 20 suggests cognitive impairment, but the MMSE of 27 is borderline normal, indicating possible mild cognitive impairment (MCI) rather than full dementia. The presence of one APOE4 allele and normal AV45 (amyloid PET) suggests mixed pathology or early-stage changes.  \n\n**Diagnosis:** MCI  \n**Confidence:** Medium (due to conflicting MMSE/MoCA scores and normal amyloid PET despite hippocampal atrophy)",
  "timestamp": "2025-07-26T16:27:05.216654"
}