{
  "ptid_time": "128_S_0225_2010-11-03",
  "img_path": "/data/qiuhui/data/adni/images/128_S_0225/2010-11-03/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 39,627 mm³, 7.2% above the reference mean. With a Z-score of 0.19 (57.7th percentile), this represents normal volume ; hippocampal volume measures 5,671 mm³, 12.7% below the reference mean. With a Z-score of -1.02 (15.5th percentile), this represents mild atrophy; whole brain volume measures 857,910 mm³, 7.6% below the reference mean. With a Z-score of -0.91 (18.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,036 mm³, 12.3% below the reference mean. With a Z-score of -0.67 (25.3th percentile), this represents normal volume ; fusiform gyrus volume measures 13,543 mm³, 15.9% below the reference mean. With a Z-score of -1.20 (11.6th percentile), this represents mild atrophy; middle temporal gyrus volume measures 16,747 mm³, 7.1% below the reference mean. With a Z-score of -0.63 (26.3th percentile), this represents normal volume . ",
  "text_data": "Age is 86.4 years. Gender is Female. Education: 17 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 29.0. MoCA: 26.0. Logical Memory: 8.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.95 SUVR (mild reduced). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal and fusiform gyrus volumes show mild atrophy (Z-scores -1.02 and -1.20, respectively), which are early markers of Alzheimer's pathology. However, cognitive scores (MMSE 29, MoCA 26) remain within normal limits, and there is no significant whole-brain or entorhinal atrophy. The absence of APOE4 and only mild amyloid burden (AV45) further reduce the likelihood of rapid progression.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Cognitive scores are preserved, but hippocampal/fusiform atrophy suggests early neurodegeneration; clinical correlation is needed to confirm functional impact.)",
  "timestamp": "2025-07-26T13:38:46.998620"
}