{
  "ptid_time": "141_S_1378_2017-06-03",
  "img_path": "/data/qiuhui/data/adni/images/141_S_1378/2017-06-03/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 47,778 mm³, 70.2% above the reference mean. With a Z-score of 1.61 (94.6th percentile), this represents moderate enlargement; hippocampal volume measures 6,131 mm³, 13.8% below the reference mean. With a Z-score of -1.27 (10.2th percentile), this represents mild atrophy; whole brain volume measures 957,894 mm³, 1.7% below the reference mean. With a Z-score of -0.22 (41.4th percentile), this represents normal volume ; entorhinal cortex volume measures 4,614 mm³, 25.6% above the reference mean. With a Z-score of 1.57 (94.2th percentile), this represents moderate enlargement; fusiform gyrus volume measures 18,549 mm³, 9.0% above the reference mean. With a Z-score of 0.82 (79.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,595 mm³, 8.2% below the reference mean. With a Z-score of -0.71 (23.8th percentile), this represents normal volume . ",
  "text_data": "Age is 71.8 years. Gender is Female. Education: 16 years. MMSE: 29.0. MoCA: 14.0. Logical Memory: 8.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.36 SUVR (significant elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows moderate ventricular enlargement and mild hippocampal atrophy, which are suggestive of neurodegenerative changes. However, the MMSE score of 29 is within the normal range, while the MoCA score of 14 indicates significant cognitive impairment, creating a discrepancy. The elevated AV45 (amyloid PET) and presence of an APOE4 allele support Alzheimer's pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer’s disease, given amyloid positivity and APOE4 status).  \n\n**Confidence:** **Medium** (due to the conflicting MMSE/MoCA scores, but structural and biomarker evidence supports early neurodegeneration).",
  "timestamp": "2025-07-26T16:59:00.175328"
}