{
  "ptid_time": "002_S_1280_2014-03-14",
  "img_path": "/data/qiuhui/data/adni/images/002_S_1280/2014-03-14/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 26,751 mm³, 4.7% below the reference mean. With a Z-score of -0.11 (45.7th percentile), this represents normal volume ; hippocampal volume measures 6,273 mm³, 11.8% below the reference mean. With a Z-score of -1.08 (13.9th percentile), this represents mild atrophy; whole brain volume measures 950,541 mm³, 2.5% below the reference mean. With a Z-score of -0.31 (37.8th percentile), this represents normal volume ; entorhinal cortex volume measures 3,066 mm³, 16.5% below the reference mean. With a Z-score of -1.01 (15.5th percentile), this represents mild atrophy; fusiform gyrus volume measures 15,581 mm³, 8.4% below the reference mean. With a Z-score of -0.77 (22.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,869 mm³, 12.0% below the reference mean. With a Z-score of -1.04 (14.9th percentile), this represents mild atrophy. ",
  "text_data": "Age is 77.7 years. Gender is Female. Education: 14 years. MMSE: 30.0. MoCA: 25.0. Logical Memory: 13.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal, entorhinal cortex, and middle temporal gyrus volumes show mild atrophy (Z-scores between -1.04 and -1.08, 13.9th–15.5th percentile), which is concerning for early neurodegeneration. However, the MMSE is normal (30/30), and the MoCA (25/30) suggests only mild cognitive impairment (MCI). The presence of one APOE4 allele increases Alzheimer’s risk but does not confirm dementia.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Structural atrophy supports MCI, but high MMSE and only mildly reduced MoCA leave some uncertainty.)",
  "timestamp": "2025-07-25T20:17:12.777630"
}