{
  "ptid_time": "137_S_0972_2014-12-09",
  "img_path": "/data/qiuhui/data/adni/images/137_S_0972/2014-12-09/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 36,584 mm³, 22.2% below the reference mean. With a Z-score of -0.64 (26.0th percentile), this represents normal volume ; hippocampal volume measures 6,313 mm³, 9.4% below the reference mean. With a Z-score of -0.81 (20.8th percentile), this represents normal volume ; whole brain volume measures 950,722 mm³, 7.6% below the reference mean. With a Z-score of -1.00 (15.9th percentile), this represents normal volume ; entorhinal cortex volume measures 2,948 mm³, 25.7% below the reference mean. With a Z-score of -1.68 (4.6th percentile), this represents moderate atrophy; fusiform gyrus volume measures 16,454 mm³, 8.9% below the reference mean. With a Z-score of -0.77 (22.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,299 mm³, 14.2% below the reference mean. With a Z-score of -1.28 (10.1th percentile), this represents mild atrophy. ",
  "text_data": "Age is 85.9 years. Gender is Male. Education: 16 years. MMSE: 27.0. MoCA: 22.0. Logical Memory: 11.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.44 SUVR (significant elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows moderate atrophy (Z-score -1.68, 4.6th percentile), and the middle temporal gyrus has mild atrophy (Z-score -1.28, 10.1th percentile), both of which are key regions affected in early Alzheimer's disease. The MMSE score of 27 is within normal limits, but the MoCA score of 22 suggests mild cognitive impairment (MCI), supported by the presence of an APOE4 allele and elevated AV45 (amyloid positivity).  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer’s pathology)  \n**Confidence:** **Medium** (clinical scores are borderline, but imaging and biomarkers suggest early neurodegenerative changes).",
  "timestamp": "2025-07-26T16:21:23.496614"
}