{
  "ptid_time": "002_S_1261_2019-05-01",
  "img_path": "/data/qiuhui/data/adni/images/002_S_1261/2019-05-01/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 66,845 mm³, 80.8% above the reference mean. With a Z-score of 2.18 (98.5th percentile), this represents significant enlargement; hippocampal volume measures 4,964 mm³, 23.6% below the reference mean. With a Z-score of -1.89 (2.9th percentile), this represents moderate atrophy; whole brain volume measures 946,938 mm³, 2.0% above the reference mean. With a Z-score of 0.24 (59.6th percentile), this represents normal volume ; entorhinal cortex volume measures 2,439 mm³, 29.6% below the reference mean. With a Z-score of -1.60 (5.5th percentile), this represents moderate atrophy; fusiform gyrus volume measures 16,364 mm³, 1.6% above the reference mean. With a Z-score of 0.12 (54.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,915 mm³, 0.6% below the reference mean. With a Z-score of -0.06 (47.8th percentile), this represents normal volume . ",
  "text_data": "Age is 83.1 years. Gender is Female. Education: 16 years. MMSE: 29.0. MoCA: 23.0. Logical Memory: 11.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.07 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant ventricular enlargement (98.5th percentile) and moderate atrophy in the hippocampus (2.9th percentile) and entorhinal cortex (5.5th percentile), which are key regions affected in Alzheimer's disease. Despite normal whole brain volume, these focal atrophies, along with a borderline MoCA score (23/30) in an 83-year-old female, suggest cognitive impairment. The absence of APOE4 and normal AV45 (amyloid PET) lowers the likelihood of typical Alzheimer's but does not rule out other neurodegenerative causes.  \n\n**Diagnosis:** **MCI (Mild Cognitive Impairment)**  \n**Confidence:** **Medium** (due to conflicting biomarkers—structural atrophy without amyloid positivity, but strong clinical and imaging evidence of decline).",
  "timestamp": "2025-07-25T20:14:33.660909"
}