{
  "ptid_time": "072_S_4610_2012-03-30",
  "img_path": "/data/qiuhui/data/adni/images/072_S_4610/2012-03-30/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 25,626 mm³, 14.7% above the reference mean. With a Z-score of 0.37 (64.4th percentile), this represents normal volume ; hippocampal volume measures 7,276 mm³, 5.3% below the reference mean. With a Z-score of -0.60 (27.5th percentile), this represents normal volume ; whole brain volume measures 861,801 mm³, 16.3% below the reference mean. With a Z-score of -2.02 (2.1th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,898 mm³, 25.6% below the reference mean. With a Z-score of -1.98 (2.4th percentile), this represents moderate atrophy; fusiform gyrus volume measures 15,561 mm³, 14.5% below the reference mean. With a Z-score of -1.64 (5.1th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 16,868 mm³, 17.8% below the reference mean. With a Z-score of -1.58 (5.7th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 67.3 years. Gender is Female. Education: 14 years. Handedness: Right. Race: Black or African American. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Endocrine-Metabolic; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 24.0. MoCA: 16.0. Logical Memory: 7.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.07 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient exhibits significant whole brain atrophy (Z-score -2.02) and moderate atrophy in key Alzheimer’s-related regions (entorhinal cortex, fusiform gyrus, middle temporal gyrus). Cognitive testing (MMSE 24, MoCA 16) suggests impairment, but the absence of APOE4 and normal AV45 (amyloid PET) complicates a typical Alzheimer’s profile.  \n**Diagnosis:** **MCI** (given structural atrophy and cognitive decline but lack of clear biomarker support for dementia).  \n**Confidence:** **Medium** (atypical biomarker profile lowers certainty).",
  "timestamp": "2025-07-26T09:24:57.828090"
}