{
  "ptid_time": "027_S_4919_2015-12-17",
  "img_path": "/data/qiuhui/data/adni/images/027_S_4919/2015-12-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 27,602 mm³, 1.7% below the reference mean. With a Z-score of -0.04 (48.5th percentile), this represents normal volume ; hippocampal volume measures 5,635 mm³, 20.8% below the reference mean. With a Z-score of -1.91 (2.8th percentile), this represents moderate atrophy; whole brain volume measures 951,159 mm³, 2.4% below the reference mean. With a Z-score of -0.30 (38.1th percentile), this represents normal volume ; entorhinal cortex volume measures 2,444 mm³, 33.5% below the reference mean. With a Z-score of -2.05 (2.0th percentile), this represents significant atrophy; fusiform gyrus volume measures 15,838 mm³, 6.9% below the reference mean. With a Z-score of -0.63 (26.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,404 mm³, 1.2% above the reference mean. With a Z-score of 0.11 (54.2th percentile), this represents normal volume . ",
  "text_data": "Age is 77.8 years. Gender is Female. Education: 19 years. MMSE: 26.0. MoCA: 24.0. Logical Memory: 10.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal and entorhinal cortex volumes show significant atrophy (Z-scores of -1.91 and -2.05, respectively), which are key regions affected in Alzheimer's disease. However, cognitive scores (MMSE 26, MoCA 24) are only mildly impaired, suggesting possible early-stage cognitive decline rather than full dementia.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Structural atrophy is concerning, but cognitive scores are borderline, and APOE4-negative status reduces certainty of rapid progression.)",
  "timestamp": "2025-07-26T04:01:35.282212"
}