{
  "ptid_time": "013_S_2389_2012-02-15",
  "img_path": "/data/qiuhui/data/adni/images/013_S_2389/2012-02-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 19,726 mm³, 5.9% above the reference mean. With a Z-score of 0.17 (56.7th percentile), this represents normal volume ; hippocampal volume measures 7,898 mm³, 1.2% above the reference mean. With a Z-score of 0.16 (56.4th percentile), this represents normal volume ; whole brain volume measures 995,905 mm³, 4.3% below the reference mean. With a Z-score of -0.51 (30.4th percentile), this represents normal volume ; entorhinal cortex volume measures 2,866 mm³, 22.4% below the reference mean. With a Z-score of -1.76 (4.0th percentile), this represents moderate atrophy; fusiform gyrus volume measures 15,025 mm³, 18.5% below the reference mean. With a Z-score of -1.68 (4.7th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 19,931 mm³, 2.9% below the reference mean. With a Z-score of -0.24 (40.5th percentile), this represents normal volume . ",
  "text_data": "Age is 58.3 years. Gender is Female. Education: 15 years. MMSE: 29.0. MoCA: 21.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex and fusiform gyrus show moderate atrophy (Z-scores -1.76 and -1.68, respectively), which are early markers of Alzheimer's pathology. However, hippocampal and whole brain volumes are within normal limits. The MMSE is normal (29/30), but the MoCA (21/30) suggests mild cognitive impairment. The absence of APOE4 reduces genetic risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting MoCA/MMSE scores and focal atrophy without widespread neurodegeneration)",
  "timestamp": "2025-07-25T23:29:55.220273"
}