{
  "ptid_time": "037_S_0303_2014-05-09",
  "img_path": "/data/qiuhui/data/adni/images/037_S_0303/2014-05-09/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 46,789 mm³, 4.3% below the reference mean. With a Z-score of -0.39 (34.9th percentile), this represents normal volume ; hippocampal volume measures 5,497 mm³, 13.7% below the reference mean. With a Z-score of -1.49 (6.8th percentile), this represents mild atrophy; whole brain volume measures 957,500 mm³, 4.4% below the reference mean. With a Z-score of -0.75 (22.6th percentile), this represents normal volume ; entorhinal cortex volume measures 3,537 mm³, 10.5% below the reference mean. With a Z-score of -0.54 (29.4th percentile), this represents normal volume ; fusiform gyrus volume measures 17,998 mm³, 6.8% above the reference mean. With a Z-score of 0.78 (78.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,166 mm³, 3.6% below the reference mean. With a Z-score of -0.56 (28.8th percentile), this represents normal volume . ",
  "text_data": "Age is 92.2 years. Gender is Male. Education: 16 years. MMSE: 29.0. MoCA: 23.0. Logical Memory: 19.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.49, 6.8th percentile), which is notable given the otherwise largely normal brain volumes. The MoCA score of 23 suggests mild cognitive impairment, while the MMSE of 29 is within normal limits, indicating possible early-stage cognitive decline. The presence of one APOE4 allele increases Alzheimer's risk but is not definitive.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting MMSE/MoCA scores and isolated hippocampal atrophy in an older adult)",
  "timestamp": "2025-07-26T06:26:07.928987"
}