{
  "ptid_time": "141_S_2333_2011-09-13",
  "img_path": "/data/qiuhui/data/adni/images/141_S_2333/2011-09-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 30,689 mm³, 2.2% above the reference mean. With a Z-score of 0.05 (52.1th percentile), this represents normal volume ; hippocampal volume measures 6,783 mm³, 15.5% below the reference mean. With a Z-score of -1.55 (6.1th percentile), this represents moderate atrophy; whole brain volume measures 1,073,290 mm³, 5.4% below the reference mean. With a Z-score of -0.76 (22.2th percentile), this represents normal volume ; entorhinal cortex volume measures 4,156 mm³, 2.5% below the reference mean. With a Z-score of -0.17 (43.1th percentile), this represents normal volume ; fusiform gyrus volume measures 19,945 mm³, 0.2% above the reference mean. With a Z-score of 0.02 (50.6th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,530 mm³, 21.8% below the reference mean. With a Z-score of -1.79 (3.6th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 67.5 years. Gender is Male. Education: 12 years. MMSE: 27.0. MoCA: 23.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows moderate atrophy (Z-score -1.55, 6.1th percentile), and the middle temporal gyrus also shows moderate atrophy (Z-score -1.79, 3.6th percentile), both of which are key regions affected in Alzheimer's disease. The MMSE (27) is within normal limits, but the MoCA (23) suggests mild cognitive impairment. The presence of one APOE4 allele increases Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to borderline MoCA and significant atrophy in memory-related regions, but no clear functional decline yet).",
  "timestamp": "2025-07-26T17:00:37.174854"
}