{
  "ptid_time": "016_S_4646_2013-05-14",
  "img_path": "/data/qiuhui/data/adni/images/016_S_4646/2013-05-14/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 19,260 mm³, 13.8% below the reference mean. With a Z-score of -0.34 (36.5th percentile), this represents normal volume ; hippocampal volume measures 7,104 mm³, 7.6% below the reference mean. With a Z-score of -0.85 (19.8th percentile), this represents normal volume ; whole brain volume measures 1,089,550 mm³, 5.9% above the reference mean. With a Z-score of 0.73 (76.7th percentile), this represents normal volume ; entorhinal cortex volume measures 3,562 mm³, 8.5% below the reference mean. With a Z-score of -0.66 (25.5th percentile), this represents normal volume ; fusiform gyrus volume measures 20,868 mm³, 14.6% above the reference mean. With a Z-score of 1.64 (95.0th percentile), this represents moderate enlargement; middle temporal gyrus volume measures 20,840 mm³, 1.6% above the reference mean. With a Z-score of 0.14 (55.5th percentile), this represents normal volume . ",
  "text_data": "Age is 61.8 years. Gender is Female. Education: 16 years. MMSE: 27.0. MoCA: 21.0. Logical Memory: 2.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are largely within normal ranges, with only the fusiform gyrus showing moderate enlargement. However, the MoCA score of 21 (below the typical cutoff of 26 for normal cognition) suggests mild cognitive impairment, while the MMSE of 27 is borderline. The presence of one APOE4 allele increases Alzheimer's risk but is not diagnostic.  \n\n**Diagnosis:** **MCI (Mild Cognitive Impairment)**  \n**Confidence:** **Medium** (Cognitive testing indicates impairment, but structural brain changes are not yet strongly indicative of dementia.)",
  "timestamp": "2025-07-26T00:29:17.882406"
}