{
  "ptid_time": "021_S_0178_2019-06-06",
  "img_path": "/data/qiuhui/data/adni/images/021_S_0178/2019-06-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 37,541 mm³, 2.5% below the reference mean. With a Z-score of -0.06 (47.6th percentile), this represents normal volume ; hippocampal volume measures 5,926 mm³, 21.6% below the reference mean. With a Z-score of -2.11 (1.8th percentile), this represents significant atrophy; whole brain volume measures 979,453 mm³, 9.3% below the reference mean. With a Z-score of -1.20 (11.5th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,988 mm³, 2.7% below the reference mean. With a Z-score of -0.19 (42.6th percentile), this represents normal volume ; fusiform gyrus volume measures 18,325 mm³, 2.7% below the reference mean. With a Z-score of -0.23 (40.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,675 mm³, 3.1% below the reference mean. With a Z-score of -0.28 (39.0th percentile), this represents normal volume . ",
  "text_data": "Age is 77.8 years. Gender is Male. Education: 20 years. MMSE: 30.0. MoCA: 25.0. Logical Memory: 13.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "Reasoning: The hippocampal volume shows significant atrophy (Z-score -2.11, 1.8th percentile), which is a strong biomarker for Alzheimer's pathology. However, cognitive scores (MMSE 30, MoCA 25) are borderline normal, and other brain regions show only mild or no atrophy. The absence of APOE4 reduces genetic risk but does not rule out AD.  \nDiagnosis: **MCI** (mild cognitive impairment)  \nConfidence: **Medium** (cognitive scores are near-normal, but hippocampal atrophy is concerning for early neurodegenerative changes)",
  "timestamp": "2025-07-26T01:22:36.012099"
}