{
  "ptid_time": "027_S_4936_2013-04-09",
  "img_path": "/data/qiuhui/data/adni/images/027_S_4936/2013-04-09/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 34,348 mm³, 10.8% below the reference mean. With a Z-score of -0.26 (39.8th percentile), this represents normal volume ; hippocampal volume measures 7,178 mm³, 5.0% below the reference mean. With a Z-score of -0.49 (31.1th percentile), this represents normal volume ; whole brain volume measures 1,104,820 mm³, 2.4% above the reference mean. With a Z-score of 0.31 (62.0th percentile), this represents normal volume ; entorhinal cortex volume measures 3,909 mm³, 4.7% below the reference mean. With a Z-score of -0.32 (37.6th percentile), this represents normal volume ; fusiform gyrus volume measures 18,214 mm³, 3.3% below the reference mean. With a Z-score of -0.28 (38.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 23,657 mm³, 10.9% above the reference mean. With a Z-score of 0.98 (83.6th percentile), this represents normal volume . ",
  "text_data": "Age is 78.6 years. Gender is Male. Education: 19 years. MMSE: 24.0. MoCA: 14.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements (ventricular, hippocampal, whole brain, entorhinal cortex, fusiform gyrus, and middle temporal gyrus) all fall within normal ranges based on Z-scores and percentiles. However, the cognitive scores (MMSE: 24, MoCA: 14) indicate significant cognitive impairment, particularly on the MoCA, which is highly suggestive of dementia. The absence of APOE4 reduces genetic risk but does not rule out dementia.  \n\n**Diagnosis:** Dementia  \n**Confidence:** Medium (due to normal brain volumes but clear cognitive deficits; further clinical correlation would strengthen confidence)",
  "timestamp": "2025-07-26T04:03:10.109688"
}