{
  "ptid_time": "073_S_4443_2014-03-27",
  "img_path": "/data/qiuhui/data/adni/images/073_S_4443/2014-03-27/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 30,680 mm³, 2.2% above the reference mean. With a Z-score of 0.05 (52.1th percentile), this represents normal volume ; hippocampal volume measures 8,358 mm³, 4.1% above the reference mean. With a Z-score of 0.41 (66.0th percentile), this represents normal volume ; whole brain volume measures 1,088,340 mm³, 4.1% below the reference mean. With a Z-score of -0.58 (28.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,626 mm³, 14.9% below the reference mean. With a Z-score of -1.03 (15.1th percentile), this represents mild atrophy; fusiform gyrus volume measures 21,479 mm³, 7.9% above the reference mean. With a Z-score of 0.66 (74.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,328 mm³, 0.4% below the reference mean. With a Z-score of -0.03 (48.8th percentile), this represents normal volume . ",
  "text_data": "Age is 69.9 years. Gender is Male. Education: 12 years. MMSE: 24.0. MoCA: 26.0. Logical Memory: 12.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.01 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows mild atrophy in the entorhinal cortex (Z-score -1.03, 15.1th percentile), while other regions (hippocampus, ventricles, whole brain, fusiform gyrus, middle temporal gyrus) are within normal ranges. The MMSE (24) is slightly below normal (typically ≤25 suggests impairment), but the MoCA (26) is within normal limits (≥26). APOE4-negative status and normal AV45 (amyloid PET) reduce the likelihood of Alzheimer’s pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to borderline cognitive scores and isolated entorhinal atrophy, but lack of significant biomarker or widespread structural abnormalities).",
  "timestamp": "2025-07-26T09:48:16.096690"
}