{
  "ptid_time": "013_S_4791_2012-12-19",
  "img_path": "/data/qiuhui/data/adni/images/013_S_4791/2012-12-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 15,740 mm³, 29.5% below the reference mean. With a Z-score of -0.74 (23.0th percentile), this represents normal volume ; hippocampal volume measures 8,474 mm³, 10.3% above the reference mean. With a Z-score of 1.15 (87.6th percentile), this represents mild enlargement; whole brain volume measures 982,371 mm³, 4.5% below the reference mean. With a Z-score of -0.57 (28.6th percentile), this represents normal volume ; entorhinal cortex volume measures 3,864 mm³, 0.7% below the reference mean. With a Z-score of -0.06 (47.7th percentile), this represents normal volume ; fusiform gyrus volume measures 17,382 mm³, 4.5% below the reference mean. With a Z-score of -0.51 (30.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,334 mm³, 4.0% above the reference mean. With a Z-score of 0.35 (63.8th percentile), this represents normal volume . ",
  "text_data": "Age is 67.6 years. Gender is Female. Education: 12 years. MMSE: 29.0. MoCA: 22.0. Logical Memory: 7.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.08 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are largely within normal ranges, with no significant atrophy in key regions like the hippocampus or entorhinal cortex. However, the MoCA score of 22 suggests mild cognitive impairment (MCI), while the MMSE of 29 is borderline normal. The presence of one APOE4 allele increases Alzheimer's risk, but the normal AV45 (amyloid PET) scan argues against significant amyloid pathology at this stage.  \n\n**Diagnosis:** **MCI** (mild cognitive impairment)  \n**Confidence:** **Medium** (due to the discrepancy between MMSE and MoCA, and the lack of clear structural or amyloid biomarkers supporting dementia)",
  "timestamp": "2025-07-25T23:35:13.749977"
}