{
  "ptid_time": "141_S_4423_2012-05-10",
  "img_path": "/data/qiuhui/data/adni/images/141_S_4423/2012-05-10/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 95,693 mm³, 148.4% above the reference mean. With a Z-score of 3.56 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 7,245 mm³, 4.2% below the reference mean. With a Z-score of -0.41 (34.3th percentile), this represents normal volume ; whole brain volume measures 1,122,420 mm³, 4.0% above the reference mean. With a Z-score of 0.52 (69.8th percentile), this represents normal volume ; entorhinal cortex volume measures 3,773 mm³, 8.0% below the reference mean. With a Z-score of -0.54 (29.4th percentile), this represents normal volume ; fusiform gyrus volume measures 18,151 mm³, 3.6% below the reference mean. With a Z-score of -0.31 (37.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,601 mm³, 5.9% above the reference mean. With a Z-score of 0.53 (70.3th percentile), this represents normal volume . ",
  "text_data": "Age is 78.1 years. Gender is Male. Education: 12 years. MMSE: 24.0. MoCA: 19.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound ventricular enlargement (Z-score 3.56), which is strongly associated with neurodegeneration, but hippocampal and other regional volumes are within normal limits (Z-scores close to 0). Cognitive testing (MMSE 24, MoCA 19) suggests mild impairment, but not severe enough for dementia. APOE4-negative status reduces Alzheimer's risk.  \n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (ventricular enlargement is concerning, but other structures are preserved, and cognitive scores are borderline).",
  "timestamp": "2025-07-26T17:03:20.598927"
}