{
  "ptid_time": "021_S_6312_2019-04-30",
  "img_path": "/data/qiuhui/data/adni/images/021_S_6312/2019-04-30/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 45,260 mm³, 3.7% below the reference mean. With a Z-score of -0.11 (45.7th percentile), this represents normal volume ; hippocampal volume measures 6,535 mm³, 6.2% below the reference mean. With a Z-score of -0.54 (29.6th percentile), this represents normal volume ; whole brain volume measures 1,081,880 mm³, 5.1% above the reference mean. With a Z-score of 0.67 (74.9th percentile), this represents normal volume ; entorhinal cortex volume measures 3,781 mm³, 4.7% below the reference mean. With a Z-score of -0.31 (37.8th percentile), this represents normal volume ; fusiform gyrus volume measures 17,169 mm³, 5.0% below the reference mean. With a Z-score of -0.43 (33.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,919 mm³, 3.7% above the reference mean. With a Z-score of 0.33 (63.0th percentile), this represents normal volume . ",
  "text_data": "Age is 81.3 years. Gender is Male. Education: 18 years. MMSE: 26.0. MoCA: 23.0. Logical Memory: 12.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements (hippocampus, entorhinal cortex, fusiform gyrus, etc.) are all within normal ranges, with Z-scores and percentiles not indicating significant atrophy. The MMSE (26) and MoCA (23) scores suggest mild cognitive impairment (MCI), particularly given the MoCA score is below the typical cutoff of 26. The presence of one APOE4 allele increases Alzheimer’s risk but does not confirm dementia.  \n\n**Diagnosis:** **MCI** (Mild Cognitive Impairment)  \n**Confidence:** **Medium** (Cognitive scores suggest MCI, but structural brain changes are not yet pronounced enough for dementia.)",
  "timestamp": "2025-07-26T01:56:50.875088"
}