{
  "ptid_time": "009_S_4359_2014-01-16",
  "img_path": "/data/qiuhui/data/adni/images/009_S_4359/2014-01-16/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 30,708 mm³, 20.3% below the reference mean. With a Z-score of -0.49 (31.4th percentile), this represents normal volume ; hippocampal volume measures 7,325 mm³, 3.1% below the reference mean. With a Z-score of -0.30 (38.1th percentile), this represents normal volume ; whole brain volume measures 1,004,380 mm³, 7.0% below the reference mean. With a Z-score of -0.90 (18.3th percentile), this represents normal volume ; entorhinal cortex volume measures 4,445 mm³, 8.4% above the reference mean. With a Z-score of 0.57 (71.6th percentile), this represents normal volume ; fusiform gyrus volume measures 15,517 mm³, 17.6% below the reference mean. With a Z-score of -1.50 (6.7th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 17,206 mm³, 19.4% below the reference mean. With a Z-score of -1.74 (4.1th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 78.7 years. Gender is Male. Education: 16 years. MMSE: 30.0. MoCA: 22.0. Logical Memory: 10.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain imaging shows moderate atrophy in the fusiform gyrus and middle temporal gyrus, which are regions often affected in neurodegenerative diseases. However, hippocampal and whole-brain volumes are within normal ranges, and cognitive testing reveals a discrepancy between a perfect MMSE (30/30) and a mildly impaired MoCA (22/30), suggesting possible subtle cognitive deficits.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting cognitive scores and focal atrophy without widespread neurodegeneration)",
  "timestamp": "2025-07-25T22:20:02.339074"
}