{
  "ptid_time": "141_S_4232_2012-12-09",
  "img_path": "/data/qiuhui/data/adni/images/141_S_4232/2012-12-09/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 18,678 mm³, 51.5% below the reference mean. With a Z-score of -1.23 (10.9th percentile), this represents mild atrophy; hippocampal volume measures 7,761 mm³, 2.7% above the reference mean. With a Z-score of 0.26 (60.3th percentile), this represents normal volume ; whole brain volume measures 1,065,760 mm³, 1.3% below the reference mean. With a Z-score of -0.16 (43.5th percentile), this represents normal volume ; entorhinal cortex volume measures 4,415 mm³, 7.7% above the reference mean. With a Z-score of 0.52 (69.8th percentile), this represents normal volume ; fusiform gyrus volume measures 17,785 mm³, 5.6% below the reference mean. With a Z-score of -0.48 (31.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,461 mm³, 8.8% below the reference mean. With a Z-score of -0.79 (21.4th percentile), this represents normal volume . ",
  "text_data": "Age is 75.2 years. Gender is Male. Education: 16 years. MMSE: 29.0. MoCA: 20.0. Logical Memory: 5.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows mild ventricular atrophy but otherwise normal brain volumes, including the hippocampus and entorhinal cortex, which are typically affected in Alzheimer's. However, the MoCA score of 20 suggests cognitive impairment, while the MMSE of 29 is within normal range, indicating possible mild cognitive impairment (MCI) rather than dementia. The absence of APOE4 reduces Alzheimer's risk but does not rule out other causes of MCI.  \n\n**Diagnosis:** MCI  \n**Confidence:** Medium (due to conflicting MMSE/MoCA scores and normal structural findings except mild ventricular enlargement)",
  "timestamp": "2025-07-26T17:03:07.396274"
}