{
  "ptid_time": "022_S_2379_2011-12-06",
  "img_path": "/data/qiuhui/data/adni/images/022_S_2379/2011-12-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 20,236 mm³, 32.6% below the reference mean. With a Z-score of -0.77 (21.9th percentile), this represents normal volume ; hippocampal volume measures 9,619 mm³, 19.8% above the reference mean. With a Z-score of 1.98 (97.6th percentile), this represents moderate enlargement; whole brain volume measures 1,196,200 mm³, 5.4% above the reference mean. With a Z-score of 0.77 (77.9th percentile), this represents normal volume ; entorhinal cortex volume measures 3,531 mm³, 17.2% below the reference mean. With a Z-score of -1.19 (11.7th percentile), this represents mild atrophy; fusiform gyrus volume measures 23,995 mm³, 20.5% above the reference mean. With a Z-score of 1.71 (95.6th percentile), this represents moderate enlargement; middle temporal gyrus volume measures 23,040 mm³, 2.8% above the reference mean. With a Z-score of 0.23 (59.1th percentile), this represents normal volume . ",
  "text_data": "Age is 66.5 years. Gender is Male. Education: 18 years. MMSE: 29.0. MoCA: 26.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal and fusiform gyrus volumes are moderately enlarged, which is atypical for Alzheimer's disease (AD), while the entorhinal cortex shows mild atrophy—a region often affected early in AD. However, cognitive scores (MMSE 29, MoCA 26) are within normal limits, and APOE4-negative status reduces genetic risk. The mixed volumetric findings (some enlargement, some normal, mild atrophy in one region) do not strongly align with typical AD progression.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to conflicting volumetric data despite normal cognition)",
  "timestamp": "2025-07-26T02:16:02.526964"
}