{
  "ptid_time": "003_S_4354_2017-06-13",
  "img_path": "/data/qiuhui/data/adni/images/003_S_4354/2017-06-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 36,492 mm³, 22.4% below the reference mean. With a Z-score of -0.65 (25.8th percentile), this represents normal volume ; hippocampal volume measures 6,371 mm³, 8.6% below the reference mean. With a Z-score of -0.74 (22.9th percentile), this represents normal volume ; whole brain volume measures 1,006,210 mm³, 2.2% below the reference mean. With a Z-score of -0.29 (38.5th percentile), this represents normal volume ; entorhinal cortex volume measures 3,040 mm³, 23.4% below the reference mean. With a Z-score of -1.53 (6.3th percentile), this represents moderate atrophy; fusiform gyrus volume measures 18,107 mm³, 0.2% above the reference mean. With a Z-score of 0.02 (50.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,811 mm³, 11.7% below the reference mean. With a Z-score of -1.05 (14.7th percentile), this represents mild atrophy. ",
  "text_data": "Age is 81.2 years. Gender is Male. Education: 14 years. MMSE: 26.0. MoCA: 27.0. Logical Memory: 10.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.03 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows moderate atrophy (Z-score -1.53, 6.3rd percentile), and the middle temporal gyrus has mild atrophy (Z-score -1.05, 14.7th percentile), which are concerning for early neurodegenerative changes. However, hippocampal and whole-brain volumes are within normal limits, and cognitive scores (MMSE 26, MoCA 27) are above typical dementia thresholds.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Atrophy in AD-vulnerable regions is present, but cognitive performance remains relatively intact, and APOE4-negative status with normal amyloid reduces certainty.)",
  "timestamp": "2025-07-25T20:53:19.335240"
}