{
  "ptid_time": "153_S_4133_2013-08-08",
  "img_path": "/data/qiuhui/data/adni/images/153_S_4133/2013-08-08/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 49,883 mm³, 6.1% above the reference mean. With a Z-score of 0.18 (57.0th percentile), this represents normal volume ; hippocampal volume measures 7,630 mm³, 9.5% above the reference mean. With a Z-score of 0.82 (79.4th percentile), this represents normal volume ; whole brain volume measures 1,044,080 mm³, 1.4% above the reference mean. With a Z-score of 0.19 (57.5th percentile), this represents normal volume ; entorhinal cortex volume measures 4,089 mm³, 3.0% above the reference mean. With a Z-score of 0.20 (57.8th percentile), this represents normal volume ; fusiform gyrus volume measures 17,814 mm³, 1.4% below the reference mean. With a Z-score of -0.12 (45.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,404 mm³, 11.1% above the reference mean. With a Z-score of 0.99 (83.9th percentile), this represents normal volume . ",
  "text_data": "Age is 81.7 years. Gender is Male. Education: 18 years. MMSE: 29.0. MoCA: 21.0. Logical Memory: 10.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.10 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** All brain volumes (ventricular, hippocampal, whole brain, entorhinal cortex, fusiform gyrus, and middle temporal gyrus) are within normal ranges, with Z-scores close to or above the mean. The MMSE score of 29 is normal, but the MoCA score of 21 suggests mild cognitive impairment (MCI). The presence of one APOE4 allele increases Alzheimer's risk, but AV45 (amyloid PET) is normal, ruling out significant amyloid pathology.  \n\n**Diagnosis:** **MCI** (due to MoCA score discrepancy with normal imaging and MMSE, but no dementia-level impairment).  \n\n**Confidence:** **Medium** (MoCA suggests MCI, but normal amyloid and structural imaging complicate the picture; clinical correlation needed).",
  "timestamp": "2025-07-26T17:11:41.059704"
}