{
  "ptid_time": "099_S_6038_2018-11-12",
  "img_path": "/data/qiuhui/data/adni/images/099_S_6038/2018-11-12/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 39,827 mm³, 3.4% above the reference mean. With a Z-score of 0.08 (53.2th percentile), this represents normal volume ; hippocampal volume measures 6,070 mm³, 19.7% below the reference mean. With a Z-score of -1.92 (2.7th percentile), this represents moderate atrophy; whole brain volume measures 946,769 mm³, 12.3% below the reference mean. With a Z-score of -1.60 (5.5th percentile), this represents moderate atrophy; entorhinal cortex volume measures 5,067 mm³, 23.6% above the reference mean. With a Z-score of 1.60 (94.5th percentile), this represents moderate enlargement; fusiform gyrus volume measures 17,035 mm³, 9.6% below the reference mean. With a Z-score of -0.82 (20.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,214 mm³, 14.6% below the reference mean. With a Z-score of -1.32 (9.4th percentile), this represents mild atrophy. ",
  "text_data": "Age is 78.4 years. Gender is Male. Education: 16 years. MMSE: 30.0. MoCA: 22.0. Logical Memory: 17.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows moderate atrophy in the hippocampus and whole brain, along with mild atrophy in the middle temporal gyrus—key regions affected in Alzheimer’s disease. Despite a normal MMSE, the MoCA score of 22 suggests mild cognitive impairment (MCI), and the absence of APOE4 does not rule out neurodegeneration.  \n\n**Diagnosis:** **MCI** (likely amnestic subtype given hippocampal atrophy)  \n**Confidence:** **Medium** (clinical-cognitive discrepancy and imaging support MCI, but lack of functional decline prevents a dementia diagnosis)",
  "timestamp": "2025-07-26T11:11:45.781984"
}