{
  "ptid_time": "127_S_4198_2017-10-02",
  "img_path": "/data/qiuhui/data/adni/images/127_S_4198/2017-10-02/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 50,978 mm³, 37.9% above the reference mean. With a Z-score of 1.02 (84.7th percentile), this represents mild enlargement; hippocampal volume measures 6,672 mm³, 2.7% above the reference mean. With a Z-score of 0.22 (58.6th percentile), this represents normal volume ; whole brain volume measures 918,818 mm³, 1.0% below the reference mean. With a Z-score of -0.12 (45.2th percentile), this represents normal volume ; entorhinal cortex volume measures 2,638 mm³, 23.8% below the reference mean. With a Z-score of -1.29 (9.9th percentile), this represents mild atrophy; fusiform gyrus volume measures 14,866 mm³, 7.7% below the reference mean. With a Z-score of -0.58 (28.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,590 mm³, 8.7% above the reference mean. With a Z-score of 0.77 (78.0th percentile), this represents normal volume . ",
  "text_data": "Age is 84.4 years. Gender is Female. Education: 16 years. MMSE: 29.0. MoCA: 25.0. Logical Memory: 8.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows mild ventricular enlargement and mild entorhinal cortex atrophy, but hippocampal and whole brain volumes are within normal ranges. Cognitive scores (MMSE 29, MoCA 25) are borderline for MCI but still relatively preserved given the age. APOE4 carrier status increases Alzheimer's risk, but structural changes are not yet severe.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to mixed findings—some atrophy but strong cognitive scores for age)",
  "timestamp": "2025-07-26T13:15:47.041689"
}