{
  "ptid_time": "073_S_4311_2012-06-19",
  "img_path": "/data/qiuhui/data/adni/images/073_S_4311/2012-06-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 31,648 mm³, 12.8% above the reference mean. With a Z-score of 0.29 (61.5th percentile), this represents normal volume ; hippocampal volume measures 5,634 mm³, 20.8% below the reference mean. With a Z-score of -1.91 (2.8th percentile), this represents moderate atrophy; whole brain volume measures 1,049,350 mm³, 7.7% above the reference mean. With a Z-score of 0.96 (83.3th percentile), this represents normal volume ; entorhinal cortex volume measures 3,066 mm³, 16.5% below the reference mean. With a Z-score of -1.01 (15.5th percentile), this represents mild atrophy; fusiform gyrus volume measures 17,876 mm³, 5.1% above the reference mean. With a Z-score of 0.46 (67.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,882 mm³, 6.7% below the reference mean. With a Z-score of -0.58 (28.0th percentile), this represents normal volume . ",
  "text_data": "Age is 73.0 years. Gender is Female. Education: 18 years. MMSE: 24.0. MoCA: 21.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows moderate hippocampal atrophy (Z-score -1.91, 2.8th percentile) and mild entorhinal cortex atrophy (Z-score -1.01, 15.5th percentile), both key regions affected in Alzheimer's disease. Cognitive testing (MMSE 24, MoCA 21) indicates mild cognitive impairment, but the absence of APOE4 and preserved whole-brain volume suggest a less aggressive progression.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to clear structural atrophy but no APOE4 and only moderately impaired cognition)",
  "timestamp": "2025-07-26T09:42:44.269668"
}