{
  "ptid_time": "094_S_4434_2016-02-04",
  "img_path": "/data/qiuhui/data/adni/images/094_S_4434/2016-02-04/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 22,635 mm³, 41.2% below the reference mean. With a Z-score of -0.99 (16.2th percentile), this represents normal volume ; hippocampal volume measures 7,181 mm³, 5.0% below the reference mean. With a Z-score of -0.49 (31.3th percentile), this represents normal volume ; whole brain volume measures 987,510 mm³, 8.5% below the reference mean. With a Z-score of -1.11 (13.5th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,164 mm³, 22.8% below the reference mean. With a Z-score of -1.55 (6.1th percentile), this represents moderate atrophy; fusiform gyrus volume measures 18,250 mm³, 3.1% below the reference mean. With a Z-score of -0.27 (39.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,395 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 70.5 years. Gender is Male. Education: 17 years. MMSE: 29.0. MoCA: 22.0. Logical Memory: 11.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.99 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows mild whole brain atrophy and moderate entorhinal cortex atrophy, which are concerning for early neurodegenerative changes. However, the MMSE score of 29 is normal, while the MoCA score of 22 suggests possible mild cognitive impairment (MCI). The absence of APOE4 and normal AV45 (amyloid PET) reduce the likelihood of Alzheimer’s pathology.  \n\n**Diagnosis:** **MCI** (due to MoCA score and entorhinal atrophy, but preserved MMSE and no significant amyloid burden).  \n\n**Confidence:** **Medium** (conflicting cognitive scores and imaging findings, but MoCA and entorhinal atrophy suggest MCI).",
  "timestamp": "2025-07-26T10:31:05.800110"
}