{
  "ptid_time": "072_S_4394_2015-01-30",
  "img_path": "/data/qiuhui/data/adni/images/072_S_4394/2015-01-30/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 40,332 mm³, 43.7% above the reference mean. With a Z-score of 1.00 (84.1th percentile), this represents mild enlargement; hippocampal volume measures 5,988 mm³, 15.8% below the reference mean. With a Z-score of -1.45 (7.3th percentile), this represents mild atrophy; whole brain volume measures 987,795 mm³, 1.3% above the reference mean. With a Z-score of 0.17 (56.7th percentile), this represents normal volume ; entorhinal cortex volume measures 2,766 mm³, 24.7% below the reference mean. With a Z-score of -1.52 (6.5th percentile), this represents moderate atrophy; fusiform gyrus volume measures 17,410 mm³, 2.3% above the reference mean. With a Z-score of 0.21 (58.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,152 mm³, 10.3% above the reference mean. With a Z-score of 0.90 (81.5th percentile), this represents normal volume . ",
  "text_data": "Age is 78.9 years. Gender is Female. Education: 18 years. MMSE: 30.0. MoCA: 29.0. Logical Memory: 13.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows mild ventricular enlargement and mild hippocampal atrophy, along with moderate entorhinal cortex atrophy—key regions affected in Alzheimer's disease (AD). However, cognitive scores (MMSE 30, MoCA 29) are intact, and APOE4-negative status reduces genetic risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (due to structural changes despite normal cognition)  \n**Confidence:** **Medium** (imaging suggests early neurodegeneration, but clinical scores are conflicting; longitudinal follow-up recommended).",
  "timestamp": "2025-07-26T09:22:00.046373"
}