{
  "ptid_time": "052_S_1250_2011-03-18",
  "img_path": "/data/qiuhui/data/adni/images/052_S_1250/2011-03-18/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 20,155 mm³, 28.2% below the reference mean. With a Z-score of -0.65 (25.9th percentile), this represents normal volume ; hippocampal volume measures 6,922 mm³, 2.7% below the reference mean. With a Z-score of -0.25 (40.2th percentile), this represents normal volume ; whole brain volume measures 803,668 mm³, 17.5% below the reference mean. With a Z-score of -2.21 (1.4th percentile), this represents significant atrophy; entorhinal cortex volume measures 3,029 mm³, 17.5% below the reference mean. With a Z-score of -1.08 (14.1th percentile), this represents mild atrophy; fusiform gyrus volume measures 16,287 mm³, 4.3% below the reference mean. With a Z-score of -0.39 (34.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 12,861 mm³, 32.9% below the reference mean. With a Z-score of -2.86 (0.2th percentile), this represents significant atrophy. ",
  "text_data": "Age is 77.2 years. Gender is Female. Education: 10 years. Handedness: Right. Race: Black or African American. Medical history: Neurologic; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal. MMSE: 29.0. MoCA: 23.0. Logical Memory: 9.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the whole brain and middle temporal gyrus, with mild atrophy in the entorhinal cortex, while hippocampal and ventricular volumes are normal. The MoCA score of 23 suggests mild cognitive impairment, but the MMSE of 29 is within the normal range, creating some discrepancy. The absence of APOE4 reduces genetic risk but does not rule out neurodegeneration.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting cognitive scores and significant atrophy in key regions but preserved hippocampal volume)",
  "timestamp": "2025-07-26T07:44:57.693894"
}