{
  "ptid_time": "153_S_2109_2012-11-06",
  "img_path": "/data/qiuhui/data/adni/images/153_S_2109/2012-11-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 53,279 mm³, 38.3% above the reference mean. With a Z-score of 0.92 (82.1th percentile), this represents normal volume ; hippocampal volume measures 6,558 mm³, 13.2% below the reference mean. With a Z-score of -1.29 (9.8th percentile), this represents mild atrophy; whole brain volume measures 1,056,530 mm³, 2.1% below the reference mean. With a Z-score of -0.28 (39.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,991 mm³, 2.7% below the reference mean. With a Z-score of -0.18 (42.8th percentile), this represents normal volume ; fusiform gyrus volume measures 18,360 mm³, 2.5% below the reference mean. With a Z-score of -0.22 (41.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,927 mm³, 16.0% below the reference mean. With a Z-score of -1.44 (7.5th percentile), this represents mild atrophy. ",
  "text_data": "Age is 77.2 years. Gender is Male. Education: 14 years. MMSE: 25.0. MoCA: 22.0. Logical Memory: 10.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.29, 9.8th percentile), and the middle temporal gyrus also exhibits mild atrophy (Z-score -1.44, 7.5th percentile). The MMSE (25) and MoCA (22) scores suggest mild cognitive impairment, while other brain regions are within normal limits. The absence of APOE4 reduces but does not eliminate Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Cognitive scores and hippocampal/middle temporal atrophy support MCI, but other regions are normal, and APOE4 is negative.)",
  "timestamp": "2025-07-26T17:08:57.510645"
}