{
  "ptid_time": "012_S_5195_2015-07-09",
  "img_path": "/data/qiuhui/data/adni/images/012_S_5195/2015-07-09/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 8,265 mm³, 63.0% below the reference mean. With a Z-score of -1.58 (5.7th percentile), this represents moderate atrophy; hippocampal volume measures 7,888 mm³, 2.6% above the reference mean. With a Z-score of 0.30 (61.7th percentile), this represents normal volume ; whole brain volume measures 990,485 mm³, 3.8% below the reference mean. With a Z-score of -0.47 (32.0th percentile), this represents normal volume ; entorhinal cortex volume measures 3,428 mm³, 11.9% below the reference mean. With a Z-score of -0.93 (17.7th percentile), this represents normal volume ; fusiform gyrus volume measures 19,503 mm³, 7.1% above the reference mean. With a Z-score of 0.80 (78.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,224 mm³, 1.4% below the reference mean. With a Z-score of -0.13 (44.9th percentile), this represents normal volume . ",
  "text_data": "Age is 67.1 years. Gender is Female. Education: 16 years. MMSE: 30.0. MoCA: 26.0. Logical Memory: 16.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 0.99 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The ventricular volume shows moderate atrophy (Z-score -1.58), but hippocampal and whole brain volumes are within normal ranges. Cognitive scores (MMSE 30, MoCA 26) are borderline for MCI but not dementia, and amyloid PET (AV45) is normal. APOE4 carrier status increases Alzheimer’s risk, but current imaging and cognitive data do not strongly support neurodegeneration.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to borderline MoCA and ventricular atrophy, but normal amyloid and preserved hippocampal volume)",
  "timestamp": "2025-07-25T23:18:23.878321"
}