{
  "ptid_time": "123_S_2363_2014-05-01",
  "img_path": "/data/qiuhui/data/adni/images/123_S_2363/2014-05-01/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 7,603 mm³, 74.7% below the reference mean. With a Z-score of -1.77 (3.8th percentile), this represents moderate atrophy; hippocampal volume measures 10,233 mm³, 27.5% above the reference mean. With a Z-score of 2.75 (99.7th percentile), this represents significant enlargement; whole brain volume measures 1,305,290 mm³, 15.1% above the reference mean. With a Z-score of 2.13 (98.3th percentile), this represents significant enlargement; entorhinal cortex volume measures 4,807 mm³, 12.8% above the reference mean. With a Z-score of 0.88 (81.1th percentile), this represents normal volume ; fusiform gyrus volume measures 20,791 mm³, 4.4% above the reference mean. With a Z-score of 0.37 (64.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,520 mm³, 0.5% above the reference mean. With a Z-score of 0.04 (51.6th percentile), this represents normal volume . ",
  "text_data": "Age is 61.8 years. Gender is Male. Education: 13 years. MMSE: 27.0. MoCA: 20.0. Logical Memory: 4.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant hippocampal and whole brain enlargement, which is atypical for Alzheimer's disease (AD), where atrophy is expected. The ventricular volume indicates moderate atrophy, but other key regions (entorhinal cortex, fusiform gyrus, middle temporal gyrus) are normal or enlarged. The MoCA score (20/30) suggests cognitive impairment, but the MMSE (27/30) is near-normal. The absence of APOE4 reduces AD risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting imaging findings—unusual enlargement in some regions but cognitive deficits present).",
  "timestamp": "2025-07-26T12:30:56.044765"
}