{
  "ptid_time": "094_S_4560_2012-10-11",
  "img_path": "/data/qiuhui/data/adni/images/094_S_4560/2012-10-11/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 26,819 mm³, 4.4% below the reference mean. With a Z-score of -0.10 (45.9th percentile), this represents normal volume ; hippocampal volume measures 6,205 mm³, 12.8% below the reference mean. With a Z-score of -1.17 (12.0th percentile), this represents mild atrophy; whole brain volume measures 916,895 mm³, 5.9% below the reference mean. With a Z-score of -0.75 (22.8th percentile), this represents normal volume ; entorhinal cortex volume measures 3,507 mm³, 4.5% below the reference mean. With a Z-score of -0.28 (39.1th percentile), this represents normal volume ; fusiform gyrus volume measures 18,866 mm³, 10.9% above the reference mean. With a Z-score of 0.99 (83.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,224 mm³, 10.1% below the reference mean. With a Z-score of -0.88 (18.9th percentile), this represents normal volume . ",
  "text_data": "Age is 70.8 years. Gender is Female. Education: 20 years. MMSE: 27.0. MoCA: 24.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.17, 12th percentile), which is a key biomarker for Alzheimer's pathology, while other brain regions are within normal ranges. Cognitive scores (MMSE 27, MoCA 24) are borderline, with MoCA slightly below the typical cutoff for normality (26), suggesting possible mild cognitive impairment. The absence of APOE4 reduces genetic risk but does not rule out neurodegeneration.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to hippocampal atrophy and borderline cognitive scores, but lack of broader atrophy or severe deficits)",
  "timestamp": "2025-07-26T10:32:12.380262"
}