{
  "ptid_time": "012_S_5195_2018-11-12",
  "img_path": "/data/qiuhui/data/adni/images/012_S_5195/2018-11-12/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 12,126 mm³, 56.8% below the reference mean. With a Z-score of -1.30 (9.7th percentile), this represents mild atrophy; hippocampal volume measures 7,873 mm³, 10.7% above the reference mean. With a Z-score of 0.98 (83.6th percentile), this represents normal volume ; whole brain volume measures 980,914 mm³, 0.6% above the reference mean. With a Z-score of 0.08 (53.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,838 mm³, 4.5% above the reference mean. With a Z-score of 0.28 (60.9th percentile), this represents normal volume ; fusiform gyrus volume measures 20,215 mm³, 18.8% above the reference mean. With a Z-score of 1.71 (95.7th percentile), this represents moderate enlargement; middle temporal gyrus volume measures 20,935 mm³, 9.2% above the reference mean. With a Z-score of 0.80 (78.8th percentile), this represents normal volume . ",
  "text_data": "Age is 70.6 years. Gender is Female. Education: 16 years. MMSE: 29.0. MoCA: 23.0. Logical Memory: 17.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain imaging shows mild ventricular atrophy but otherwise normal or even enlarged volumes in key regions (hippocampus, entorhinal cortex, fusiform gyrus). The MMSE is normal (29/30), but the MoCA (23/30) suggests mild cognitive impairment, possibly due to non-Alzheimer's causes given the lack of significant atrophy and APOE4 heterozygosity.  \n\n**Diagnosis:** **MCI** (Mild Cognitive Impairment)  \n**Confidence:** **Medium** (MoCA indicates cognitive deficits, but imaging does not strongly support neurodegenerative pathology; APOE4 status is only a moderate risk factor).",
  "timestamp": "2025-07-25T23:18:31.396757"
}