{
  "ptid_time": "013_S_1186_2011-02-23",
  "img_path": "/data/qiuhui/data/adni/images/013_S_1186/2011-02-23/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 40,094 mm³, 14.7% below the reference mean. With a Z-score of -0.43 (33.4th percentile), this represents normal volume ; hippocampal volume measures 6,643 mm³, 4.7% below the reference mean. With a Z-score of -0.40 (34.3th percentile), this represents normal volume ; whole brain volume measures 1,080,880 mm³, 5.0% above the reference mean. With a Z-score of 0.66 (74.5th percentile), this represents normal volume ; entorhinal cortex volume measures 3,849 mm³, 3.0% below the reference mean. With a Z-score of -0.20 (42.2th percentile), this represents normal volume ; fusiform gyrus volume measures 19,297 mm³, 6.8% above the reference mean. With a Z-score of 0.59 (72.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,223 mm³, 0.3% above the reference mean. With a Z-score of 0.02 (50.9th percentile), this represents normal volume . ",
  "text_data": "Age is 87.2 years. Gender is Male. Education: 12 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Renal-Genitourinary. MMSE: 26.0. MoCA: 21.0. Logical Memory: 5.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.30 SUVR (moderate elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are all within normal ranges (Z-scores close to 0, percentiles near 50th), suggesting no significant atrophy. However, the MoCA score of 21 (below the typical cutoff of 26) indicates mild cognitive impairment, while the MMSE of 26 is borderline normal. The moderate AV45 (amyloid) elevation suggests possible Alzheimer's pathology, but the absence of APOE4 reduces genetic risk.  \n\n**Diagnosis:** **MCI (Mild Cognitive Impairment)**  \n**Confidence:** **Medium** (Cognitive scores suggest impairment, but structural imaging is normal, and amyloid positivity is only moderate without APOE4.)",
  "timestamp": "2025-07-25T23:26:19.961553"
}