{
  "ptid_time": "033_S_1098_2011-11-21",
  "img_path": "/data/qiuhui/data/adni/images/033_S_1098/2011-11-21/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 25,841 mm³, 7.9% below the reference mean. With a Z-score of -0.18 (42.8th percentile), this represents normal volume ; hippocampal volume measures 5,772 mm³, 18.9% below the reference mean. With a Z-score of -1.73 (4.2th percentile), this represents moderate atrophy; whole brain volume measures 808,573 mm³, 17.0% below the reference mean. With a Z-score of -2.15 (1.6th percentile), this represents significant atrophy; entorhinal cortex volume measures 3,655 mm³, 0.5% below the reference mean. With a Z-score of -0.03 (48.8th percentile), this represents normal volume ; fusiform gyrus volume measures 16,532 mm³, 2.8% below the reference mean. With a Z-score of -0.26 (39.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,980 mm³, 11.4% below the reference mean. With a Z-score of -0.99 (16.1th percentile), this represents normal volume . ",
  "text_data": "Age is 77.0 years. Gender is Female. Education: 15 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 29.0. MoCA: 23.0. Logical Memory: 16.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal and whole brain volumes show moderate to significant atrophy (Z-scores of -1.73 and -2.15, respectively), which are concerning for neurodegenerative changes. However, the MMSE is normal (29/30), while the MoCA (23/30) suggests mild cognitive impairment (MCI). The presence of one APOE4 allele increases Alzheimer's risk but does not confirm dementia.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (imaging supports neurodegeneration, but cognitive scores are borderline, and functional impairment is unclear).",
  "timestamp": "2025-07-26T05:29:23.513098"
}