{
  "ptid_time": "116_S_6550_2018-08-08",
  "img_path": "/data/qiuhui/data/adni/images/116_S_6550/2018-08-08/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 24,970 mm³, 34.1% above the reference mean. With a Z-score of 0.98 (83.5th percentile), this represents normal volume ; hippocampal volume measures 8,416 mm³, 7.8% above the reference mean. With a Z-score of 1.08 (86.1th percentile), this represents mild enlargement; whole brain volume measures 1,243,800 mm³, 19.5% above the reference mean. With a Z-score of 2.34 (99.0th percentile), this represents significant enlargement; entorhinal cortex volume measures 5,729 mm³, 55.0% above the reference mean. With a Z-score of 4.31 (100.0th percentile), this represents profound enlargement; fusiform gyrus volume measures 20,742 mm³, 12.5% above the reference mean. With a Z-score of 1.14 (87.2th percentile), this represents mild enlargement; middle temporal gyrus volume measures 23,093 mm³, 12.5% above the reference mean. With a Z-score of 1.03 (84.8th percentile), this represents mild enlargement. ",
  "text_data": "Age is 55.9 years. Gender is Female. Education: 13 years. Handedness: Right. Race: White. MMSE: 29.0. MoCA: 21.0. Logical Memory: 4.0. APOEε4 alleles: 0.0. Biomarker levels: Flobetaben (FBB): 1.04 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows significant enlargement in multiple regions (whole brain, entorhinal cortex, fusiform gyrus, middle temporal gyrus) with no atrophy, which is atypical for Alzheimer's. The MMSE (29/30) is normal, but the MoCA (21/30) suggests mild cognitive impairment. The absence of APOE4 reduces genetic risk.  \n\n**Diagnosis:** **MCI** (due to MoCA score discrepancy, despite normal brain volumes)  \n**Confidence:** **Medium** (unusual volumetric findings complicate interpretation, but MoCA suggests cognitive decline)",
  "timestamp": "2025-07-26T12:19:28.022325"
}