{
  "ptid_time": "037_S_0303_2016-04-29",
  "img_path": "/data/qiuhui/data/adni/images/037_S_0303/2016-04-29/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 48,455 mm³, 0.9% below the reference mean. With a Z-score of -0.08 (46.9th percentile), this represents normal volume ; hippocampal volume measures 5,480 mm³, 14.0% below the reference mean. With a Z-score of -1.52 (6.4th percentile), this represents moderate atrophy; whole brain volume measures 950,489 mm³, 5.1% below the reference mean. With a Z-score of -0.87 (19.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,189 mm³, 19.3% below the reference mean. With a Z-score of -0.99 (16.0th percentile), this represents normal volume ; fusiform gyrus volume measures 19,392 mm³, 15.1% above the reference mean. With a Z-score of 1.74 (95.9th percentile), this represents moderate enlargement; middle temporal gyrus volume measures 18,094 mm³, 4.0% below the reference mean. With a Z-score of -0.62 (26.8th percentile), this represents normal volume . ",
  "text_data": "Age is 94.2 years. Gender is Male. Education: 16 years. MMSE: 30.0. MoCA: 26.0. Logical Memory: 15.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows moderate atrophy (Z-score -1.52, 6.4th percentile), which is a key biomarker for Alzheimer’s pathology, while other brain regions are largely within normal ranges. Despite the hippocampal atrophy, cognitive scores (MMSE 30, MoCA 26) remain intact for age, suggesting preserved function. The presence of one APOE4 allele increases Alzheimer’s risk but does not confirm disease.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Cognitive scores are normal, but hippocampal atrophy suggests early neurodegeneration; clinical correlation is needed to confirm functional impact.)",
  "timestamp": "2025-07-26T06:26:14.966914"
}