{
  "ptid_time": "024_S_4392_2012-07-09",
  "img_path": "/data/qiuhui/data/adni/images/024_S_4392/2012-07-09/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 41,404 mm³, 11.9% below the reference mean. With a Z-score of -0.35 (36.4th percentile), this represents normal volume ; hippocampal volume measures 5,767 mm³, 17.2% below the reference mean. With a Z-score of -1.49 (6.8th percentile), this represents mild atrophy; whole brain volume measures 1,056,920 mm³, 2.7% above the reference mean. With a Z-score of 0.35 (63.8th percentile), this represents normal volume ; entorhinal cortex volume measures 2,946 mm³, 25.8% below the reference mean. With a Z-score of -1.69 (4.6th percentile), this represents moderate atrophy; fusiform gyrus volume measures 18,103 mm³, 0.2% above the reference mean. With a Z-score of 0.02 (50.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,818 mm³, 1.8% below the reference mean. With a Z-score of -0.16 (43.8th percentile), this represents normal volume . ",
  "text_data": "Age is 82.9 years. Gender is Male. Education: 12 years. MMSE: 26.0. MoCA: 26.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "Reasoning: The hippocampal and entorhinal cortex volumes show mild to moderate atrophy (Z-scores -1.49 and -1.69, respectively), which are key regions affected in Alzheimer's disease. However, cognitive scores (MMSE 26, MoCA 26) are within normal limits for age, suggesting preserved function despite structural changes.  \nDiagnosis: **MCI** (structural changes present but no significant cognitive impairment yet).  \nConfidence: **Medium** (cognitive scores are borderline, and APOE4-negative status reduces but doesn't eliminate Alzheimer's risk).",
  "timestamp": "2025-07-26T03:20:56.089018"
}