{
  "ptid_time": "009_S_5176_2015-07-02",
  "img_path": "/data/qiuhui/data/adni/images/009_S_5176/2015-07-02/t1.nii.gz",
  "img_finding": "Image findings: hippocampal volume measures 6,739 mm³, 12.3% below the reference mean. With a Z-score of -1.38 (8.4th percentile), this represents mild atrophy; whole brain volume measures 1,031,710 mm³, 0.2% above the reference mean. With a Z-score of 0.03 (51.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,526 mm³, 9.4% below the reference mean. With a Z-score of -0.73 (23.3th percentile), this represents normal volume ; fusiform gyrus volume measures 18,178 mm³, 0.2% below the reference mean. With a Z-score of -0.02 (49.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,403 mm³, 5.4% below the reference mean. With a Z-score of -0.48 (31.4th percentile), this represents normal volume . ",
  "text_data": "Age is 67.7 years. Gender is Female. Education: 18 years. MMSE: 30.0. MoCA: 28.0. Logical Memory: 20.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.15 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.38, 8.4th percentile), which is concerning for early neurodegenerative changes, but other brain regions (whole brain, entorhinal cortex, fusiform gyrus, middle temporal gyrus) are within normal ranges. Cognitive scores (MMSE 30, MoCA 28) are intact, and amyloid PET (AV45) is normal, making Alzheimer’s pathology less likely.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely non-amnestic or non-AD etiology given preserved cognition and normal amyloid).  \n**Confidence:** **Medium** (hippocampal atrophy suggests neurodegeneration, but normal cognition and amyloid reduce certainty).  \n\n*Note: Given the normal amyloid and strong cognitive performance, alternative causes (e.g., vascular, psychiatric, or non-AD neurodegenerative processes) should be considered.*",
  "timestamp": "2025-07-25T22:27:46.977307"
}