{
  "ptid_time": "021_S_0337_2017-05-31",
  "img_path": "/data/qiuhui/data/adni/images/021_S_0337/2017-05-31/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 127,262 mm³, 170.7% above the reference mean. With a Z-score of 4.96 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 6,947 mm³, 0.3% below the reference mean. With a Z-score of -0.03 (48.9th percentile), this represents normal volume ; whole brain volume measures 1,056,780 mm³, 2.7% above the reference mean. With a Z-score of 0.35 (63.7th percentile), this represents normal volume ; entorhinal cortex volume measures 3,510 mm³, 11.6% below the reference mean. With a Z-score of -0.76 (22.5th percentile), this represents normal volume ; fusiform gyrus volume measures 15,283 mm³, 15.4% below the reference mean. With a Z-score of -1.33 (9.1th percentile), this represents mild atrophy; middle temporal gyrus volume measures 25,272 mm³, 25.3% above the reference mean. With a Z-score of 2.27 (98.8th percentile), this represents significant enlargement. ",
  "text_data": "Age is 86.8 years. Gender is Male. Education: 20 years. MMSE: 30.0. MoCA: 28.0. Logical Memory: 17.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 0.93 SUVR (mild reduced). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The patient shows profound ventricular enlargement (Z-score 4.96) and mild fusiform gyrus atrophy (Z-score -1.33), but hippocampal and whole brain volumes are normal. Despite structural changes, cognitive scores (MMSE 30, MoCA 28) remain intact, suggesting no functional impairment. APOE4 positivity and mild AV45 reduction indicate amyloid pathology, but clinical cognition is preserved.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (given structural and biomarker abnormalities without overt dementia symptoms).  \n\n**Confidence:** **Medium** (cognitive scores are strong, but imaging/biomarkers suggest early neurodegeneration).",
  "timestamp": "2025-07-26T01:30:22.714913"
}