{
  "ptid_time": "941_S_4420_2013-03-25",
  "img_path": "/data/qiuhui/data/adni/images/941_S_4420/2013-03-25/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 47,267 mm³, 0.5% above the reference mean. With a Z-score of 0.02 (50.6th percentile), this represents normal volume ; hippocampal volume measures 7,422 mm³, 6.5% above the reference mean. With a Z-score of 0.56 (71.3th percentile), this represents normal volume ; whole brain volume measures 1,121,090 mm³, 8.9% above the reference mean. With a Z-score of 1.17 (87.9th percentile), this represents mild enlargement; entorhinal cortex volume measures 4,430 mm³, 11.6% above the reference mean. With a Z-score of 0.76 (77.6th percentile), this represents normal volume ; fusiform gyrus volume measures 16,399 mm³, 9.2% below the reference mean. With a Z-score of -0.80 (21.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,250 mm³, 14.5% below the reference mean. With a Z-score of -1.30 (9.7th percentile), this represents mild atrophy. ",
  "text_data": "Age is 82.4 years. Gender is Male. Education: 18 years. MMSE: 27.0. MoCA: 16.0. Logical Memory: 8.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows mostly normal or above-average volumes, with only mild atrophy in the middle temporal gyrus. However, the MoCA score of 16 is significantly below the normal cutoff (typically <26 suggests impairment), while the MMSE of 27 is within the normal range (≥24). This discrepancy, along with the absence of APOE4, suggests possible mild cognitive impairment (MCI) rather than dementia or normal cognition.  \n\n**Diagnosis:** MCI  \n**Confidence:** Medium (due to the conflicting MMSE/MoCA scores and lack of significant structural atrophy)",
  "timestamp": "2025-07-26T17:42:40.879092"
}