{
  "ptid_time": "005_S_6427_2018-06-25",
  "img_path": "/data/qiuhui/data/adni/images/005_S_6427/2018-06-25/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 25,797 mm³, 15.5% above the reference mean. With a Z-score of 0.39 (65.1th percentile), this represents normal volume ; hippocampal volume measures 7,228 mm³, 5.9% below the reference mean. With a Z-score of -0.67 (25.2th percentile), this represents normal volume ; whole brain volume measures 934,847 mm³, 9.2% below the reference mean. With a Z-score of -1.14 (12.7th percentile), this represents mild atrophy; entorhinal cortex volume measures 4,543 mm³, 16.7% above the reference mean. With a Z-score of 1.29 (90.2th percentile), this represents mild enlargement; fusiform gyrus volume measures 18,573 mm³, 2.0% above the reference mean. With a Z-score of 0.22 (58.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,458 mm³, 10.0% below the reference mean. With a Z-score of -0.89 (18.6th percentile), this represents normal volume . ",
  "text_data": "Age is 65.3 years. Gender is Female. Education: 16 years. Handedness: Right. Race: White. MMSE: 27.0. MoCA: 23.0. Logical Memory: 10.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.04 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain imaging shows mild whole-brain atrophy (Z-score -1.14, 12.7th percentile) but otherwise normal hippocampal and ventricular volumes. The MMSE (27) is within normal limits, but the MoCA (23) suggests mild cognitive impairment. No APOE4 risk allele or abnormal amyloid (AV45 normal) reduces Alzheimer's likelihood.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting MMSE/MoCA scores and lack of clear biomarker support for neurodegeneration)",
  "timestamp": "2025-07-25T21:25:45.078910"
}