{
  "ptid_time": "023_S_6723_2019-04-19",
  "img_path": "/data/qiuhui/data/adni/images/023_S_6723/2019-04-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 12,692 mm³, 43.2% below the reference mean. With a Z-score of -1.08 (14.0th percentile), this represents mild atrophy; hippocampal volume measures 8,525 mm³, 10.9% above the reference mean. With a Z-score of 1.23 (89.0th percentile), this represents mild enlargement; whole brain volume measures 1,114,790 mm³, 8.3% above the reference mean. With a Z-score of 1.04 (85.0th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,271 mm³, 16.0% below the reference mean. With a Z-score of -1.24 (10.8th percentile), this represents mild atrophy; fusiform gyrus volume measures 16,185 mm³, 11.1% below the reference mean. With a Z-score of -1.25 (10.5th percentile), this represents mild atrophy; middle temporal gyrus volume measures 24,545 mm³, 19.6% above the reference mean. With a Z-score of 1.74 (95.9th percentile), this represents moderate enlargement. ",
  "text_data": "Age is 64.0 years. Gender is Female. Education: 14 years. Handedness: Right. Race: White. MMSE: 24.0. MoCA: 19.0. Logical Memory: 7.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.07 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows mixed findings—mild atrophy in the entorhinal cortex and fusiform gyrus (key regions in Alzheimer's pathology) but enlargement in the hippocampus and middle temporal gyrus, which is atypical for Alzheimer's. The MMSE (24) and MoCA (19) scores suggest cognitive impairment, but the absence of APOE4 and normal AV45 (amyloid PET) reduces the likelihood of typical Alzheimer's.  \n\n**Diagnosis:** **MCI (Mild Cognitive Impairment)**  \n**Confidence:** **Medium** (due to conflicting imaging findings and lack of biomarker support for Alzheimer's)",
  "timestamp": "2025-07-26T03:11:25.860323"
}