{
  "ptid_time": "072_S_0315_2011-04-12",
  "img_path": "/data/qiuhui/data/adni/images/072_S_0315/2011-04-12/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 31,099 mm³, 19.3% below the reference mean. With a Z-score of -0.46 (32.2th percentile), this represents normal volume ; hippocampal volume measures 8,519 mm³, 12.7% above the reference mean. With a Z-score of 1.24 (89.2th percentile), this represents mild enlargement; whole brain volume measures 1,139,160 mm³, 5.5% above the reference mean. With a Z-score of 0.72 (76.4th percentile), this represents normal volume ; entorhinal cortex volume measures 4,132 mm³, 0.8% above the reference mean. With a Z-score of 0.05 (52.1th percentile), this represents normal volume ; fusiform gyrus volume measures 15,408 mm³, 18.2% below the reference mean. With a Z-score of -1.55 (6.0th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 20,565 mm³, 3.6% below the reference mean. With a Z-score of -0.33 (37.2th percentile), this represents normal volume . ",
  "text_data": "Age is 76.5 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Musculoskeletal; Endocrine-Metabolic; Malignancy; Major Surgical Procedures. MMSE: 30.0. MoCA: 22.0. Logical Memory: 13.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.96 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The patient shows moderate atrophy in the fusiform gyrus (Z-score -1.55, 6th percentile), which is concerning for early neurodegenerative changes, but other key regions (hippocampus, entorhinal cortex, whole brain) are normal or even enlarged. Cognitive testing reveals a normal MMSE (30/30) but borderline MoCA (22/30), suggesting possible mild cognitive inefficiencies. The absence of APOE4 and normal AV45 (amyloid PET) reduces the likelihood of Alzheimer’s pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting imaging findings—fusiform atrophy vs. normal/enlarged volumes elsewhere—and borderline MoCA, but no clear dementia-level deficits or biomarker support for AD).",
  "timestamp": "2025-07-26T09:07:39.742179"
}