{
  "ptid_time": "126_S_4507_2013-03-25",
  "img_path": "/data/qiuhui/data/adni/images/126_S_4507/2013-03-25/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 64,529 mm³, 67.5% above the reference mean. With a Z-score of 1.62 (94.7th percentile), this represents moderate enlargement; hippocampal volume measures 6,304 mm³, 16.6% below the reference mean. With a Z-score of -1.62 (5.3th percentile), this represents moderate atrophy; whole brain volume measures 1,108,970 mm³, 2.7% above the reference mean. With a Z-score of 0.36 (63.9th percentile), this represents normal volume ; entorhinal cortex volume measures 3,438 mm³, 16.2% below the reference mean. With a Z-score of -1.10 (13.7th percentile), this represents mild atrophy; fusiform gyrus volume measures 17,913 mm³, 4.9% below the reference mean. With a Z-score of -0.42 (33.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,577 mm³, 1.1% above the reference mean. With a Z-score of 0.10 (54.0th percentile), this represents normal volume . ",
  "text_data": "Age is 79.2 years. Gender is Male. Education: 16 years. MMSE: 26.0. MoCA: 27.0. Logical Memory: 2.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows moderate hippocampal and mild entorhinal cortex atrophy, both key regions in Alzheimer's pathology, alongside moderate ventricular enlargement (a marker of brain atrophy). However, cognitive scores (MMSE 26, MoCA 27) are within normal limits, suggesting preserved function despite structural changes.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Structural changes are concerning, but cognitive scores are borderline normal; APOE4 carrier status increases risk but doesn't confirm progression.)  \n\n*Note:* The discrepancy between imaging and cognition could reflect early-stage MCI or resilient cognitive reserve. Close monitoring for decline is recommended.",
  "timestamp": "2025-07-26T12:46:51.776644"
}