{
  "ptid_time": "016_S_4121_2012-01-23",
  "img_path": "/data/qiuhui/data/adni/images/016_S_4121/2012-01-23/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 33,326 mm³, 29.1% below the reference mean. With a Z-score of -0.85 (19.9th percentile), this represents normal volume ; hippocampal volume measures 5,863 mm³, 15.9% below the reference mean. With a Z-score of -1.37 (8.5th percentile), this represents mild atrophy; whole brain volume measures 957,907 mm³, 6.9% below the reference mean. With a Z-score of -0.91 (18.2th percentile), this represents normal volume ; entorhinal cortex volume measures 4,069 mm³, 2.5% above the reference mean. With a Z-score of 0.16 (56.5th percentile), this represents normal volume ; fusiform gyrus volume measures 19,678 mm³, 8.9% above the reference mean. With a Z-score of 0.77 (78.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,471 mm³, 3.5% below the reference mean. With a Z-score of -0.31 (37.8th percentile), this represents normal volume . ",
  "text_data": "Age is 89.5 years. Gender is Male. Education: 16 years. MMSE: 28.0. MoCA: 20.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.37, 8.5th percentile), which is concerning for early neurodegeneration, while other brain regions are within normal ranges. The MoCA score of 20/30 suggests mild cognitive impairment, whereas the MMSE of 28/30 is less sensitive. The absence of APOE4 reduces genetic risk but does not rule out pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to hippocampal atrophy and MoCA score, but MMSE is near-normal and no APOE4 risk)",
  "timestamp": "2025-07-26T00:25:38.443601"
}