{
  "ptid_time": "067_S_4767_2014-06-09",
  "img_path": "/data/qiuhui/data/adni/images/067_S_4767/2014-06-09/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 56,301 mm³, 152.1% above the reference mean. With a Z-score of 3.81 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 6,278 mm³, 18.3% below the reference mean. With a Z-score of -2.05 (2.0th percentile), this represents significant atrophy; whole brain volume measures 919,338 mm³, 10.7% below the reference mean. With a Z-score of -1.33 (9.2th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,913 mm³, 25.2% below the reference mean. With a Z-score of -1.95 (2.6th percentile), this represents moderate atrophy; fusiform gyrus volume measures 15,688 mm³, 13.8% below the reference mean. With a Z-score of -1.56 (5.9th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 17,585 mm³, 14.3% below the reference mean. With a Z-score of -1.27 (10.2th percentile), this represents mild atrophy. ",
  "text_data": "Age is 68.4 years. Gender is Female. Education: 18 years. MMSE: 26.0. MoCA: 28.0. Logical Memory: 14.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.15 SUVR (normal ); Amyloid beta: 674.20 pg/mL (normal ); Total tau: 162.70 pg/mL (normal ); Phosphorylated tau: 16.37 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant hippocampal atrophy (Z-score -2.05) and moderate entorhinal cortex atrophy (Z-score -1.95), both strongly associated with Alzheimer's pathology, alongside profound ventricular enlargement (Z-score 3.81). However, cognitive scores (MMSE 26, MoCA 28) are within normal limits, and biomarkers (Aβ, T-tau, P-tau, AV45) are normal, suggesting no current biochemical evidence of Alzheimer’s.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Structural changes are concerning, but normal cognition and biomarkers complicate a dementia diagnosis. MCI is likely due to hippocampal/entorhinal atrophy, but progression is uncertain without biomarker support.)",
  "timestamp": "2025-07-26T08:40:21.629156"
}