{
  "ptid_time": "027_S_4873_2012-08-08",
  "img_path": "/data/qiuhui/data/adni/images/027_S_4873/2012-08-08/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 48,596 mm³, 3.4% above the reference mean. With a Z-score of 0.10 (53.9th percentile), this represents normal volume ; hippocampal volume measures 6,030 mm³, 13.5% below the reference mean. With a Z-score of -1.16 (12.2th percentile), this represents mild atrophy; whole brain volume measures 1,094,310 mm³, 6.3% above the reference mean. With a Z-score of 0.83 (79.7th percentile), this represents normal volume ; entorhinal cortex volume measures 3,435 mm³, 13.5% below the reference mean. With a Z-score of -0.88 (18.9th percentile), this represents normal volume ; fusiform gyrus volume measures 17,961 mm³, 0.6% below the reference mean. With a Z-score of -0.05 (48.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,752 mm³, 7.0% below the reference mean. With a Z-score of -0.63 (26.4th percentile), this represents normal volume . ",
  "text_data": "Age is 82.6 years. Gender is Male. Education: 12 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Allergies or Drug Sensitivities; Smoking; Malignancy; Major Surgical Procedures. MMSE: 26.0. MoCA: 21.0. Logical Memory: 4.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.97 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.16, 12.2th percentile), which is a key biomarker for Alzheimer’s disease, while other brain regions are within normal limits. The MMSE (26) is borderline, but the MoCA (21) suggests mild cognitive impairment. The absence of APOE4 and normal AV45 (amyloid PET) reduces the likelihood of Alzheimer’s pathology but does not rule out other neurodegenerative causes.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to hippocampal atrophy and cognitive scores, but lack of amyloid positivity complicates a definitive Alzheimer’s diagnosis)",
  "timestamp": "2025-07-26T04:00:18.328389"
}