{
  "ptid_time": "153_S_2109_2011-10-25",
  "img_path": "/data/qiuhui/data/adni/images/153_S_2109/2011-10-25/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 50,943 mm³, 32.3% above the reference mean. With a Z-score of 0.77 (78.0th percentile), this represents normal volume ; hippocampal volume measures 6,433 mm³, 14.9% below the reference mean. With a Z-score of -1.45 (7.3th percentile), this represents mild atrophy; whole brain volume measures 1,065,840 mm³, 1.3% below the reference mean. With a Z-score of -0.16 (43.5th percentile), this represents normal volume ; entorhinal cortex volume measures 3,817 mm³, 6.9% below the reference mean. With a Z-score of -0.47 (32.0th percentile), this represents normal volume ; fusiform gyrus volume measures 17,868 mm³, 5.2% below the reference mean. With a Z-score of -0.44 (33.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,439 mm³, 18.3% below the reference mean. With a Z-score of -1.64 (5.0th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 76.2 years. Gender is Male. Education: 14 years. Handedness: Right. Race: White. Medical history: Cardiovascular; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 28.0. MoCA: 23.0. Logical Memory: 3.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "Reasoning: The hippocampal volume shows mild atrophy (Z-score -1.45, 7.3th percentile), and the middle temporal gyrus shows moderate atrophy (Z-score -1.64, 5.0th percentile), which are concerning for early neurodegenerative changes. The MMSE is normal (28/30), but the MoCA (23/30) suggests mild cognitive impairment (MCI). No APOE4 allele reduces but does not eliminate Alzheimer’s risk.  \n\nDiagnosis: **Mild Cognitive Impairment (MCI)**  \nConfidence: **Medium** (due to borderline MoCA and atrophy in key regions, but no clear dementia-level deficits)",
  "timestamp": "2025-07-26T17:08:47.251418"
}