{
  "ptid_time": "137_S_0973_2010-12-03",
  "img_path": "/data/qiuhui/data/adni/images/137_S_0973/2010-12-03/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 66,518 mm³, 41.5% above the reference mean. With a Z-score of 1.20 (88.6th percentile), this represents mild enlargement; hippocampal volume measures 6,605 mm³, 5.2% below the reference mean. With a Z-score of -0.45 (32.6th percentile), this represents normal volume ; whole brain volume measures 985,712 mm³, 4.2% below the reference mean. With a Z-score of -0.55 (29.0th percentile), this represents normal volume ; entorhinal cortex volume measures 4,214 mm³, 6.2% above the reference mean. With a Z-score of 0.40 (65.7th percentile), this represents normal volume ; fusiform gyrus volume measures 18,909 mm³, 4.7% above the reference mean. With a Z-score of 0.40 (65.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,876 mm³, 6.4% below the reference mean. With a Z-score of -0.58 (28.2th percentile), this represents normal volume . ",
  "text_data": "Age is 80.8 years. Gender is Male. Education: 20 years. Handedness: Right. Race: White. MMSE: 21.0. MoCA: 16.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.88 SUVR (moderate reduced). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows mild ventricular enlargement (41.5% above mean) but otherwise normal brain volumes, including hippocampal volume (only 5.2% below mean). However, cognitive testing (MMSE 21, MoCA 16) indicates significant impairment, which is inconsistent with normal aging but aligns with MCI or early dementia. The absence of APOE4 and moderate amyloid burden (AV45) suggests possible non-AD pathology or mixed etiology.  \n\n**Diagnosis:** **Dementia** (likely non-Alzheimer's or mixed etiology given cognitive decline despite relatively preserved hippocampal volume and no APOE4).  \n\n**Confidence:** **Medium** (cognitive scores strongly suggest dementia, but structural changes are mild, and amyloid burden is only moderate).",
  "timestamp": "2025-07-26T16:22:18.619505"
}