{
  "ptid_time": "099_S_4565_2014-04-23",
  "img_path": "/data/qiuhui/data/adni/images/099_S_4565/2014-04-23/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 21,130 mm³, 55.1% below the reference mean. With a Z-score of -1.60 (5.5th percentile), this represents moderate atrophy; hippocampal volume measures 6,839 mm³, 1.9% below the reference mean. With a Z-score of -0.16 (43.6th percentile), this represents normal volume ; whole brain volume measures 982,078 mm³, 4.6% below the reference mean. With a Z-score of -0.60 (27.4th percentile), this represents normal volume ; entorhinal cortex volume measures 3,639 mm³, 8.3% below the reference mean. With a Z-score of -0.54 (29.3th percentile), this represents normal volume ; fusiform gyrus volume measures 18,431 mm³, 2.0% above the reference mean. With a Z-score of 0.17 (56.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,648 mm³, 7.6% below the reference mean. With a Z-score of -0.68 (24.9th percentile), this represents normal volume . ",
  "text_data": "Age is 84.4 years. Gender is Male. Education: 12 years. MMSE: 28.0. MoCA: 24.0. Logical Memory: 11.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The ventricular volume shows moderate atrophy (Z-score -1.60), but hippocampal, whole brain, entorhinal cortex, fusiform gyrus, and middle temporal gyrus volumes are within normal ranges. Cognitive scores (MMSE 28, MoCA 24) are borderline for MCI but not strongly indicative of dementia. The absence of APOE4 reduces genetic risk.  \n\n**Diagnosis:** **MCI (Mild Cognitive Impairment)**  \n**Confidence:** **Medium** (due to borderline cognitive scores and isolated ventricular atrophy in an older individual, but no clear dementia-level impairment or widespread neurodegeneration)",
  "timestamp": "2025-07-26T11:10:55.927679"
}