{
  "ptid_time": "135_S_6586_2019-10-25",
  "img_path": "/data/qiuhui/data/adni/images/135_S_6586/2019-10-25/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 54,466 mm³, 41.4% above the reference mean. With a Z-score of 0.99 (83.9th percentile), this represents normal volume ; hippocampal volume measures 6,891 mm³, 8.8% below the reference mean. With a Z-score of -0.86 (19.4th percentile), this represents normal volume ; whole brain volume measures 1,068,720 mm³, 1.0% below the reference mean. With a Z-score of -0.13 (44.9th percentile), this represents normal volume ; entorhinal cortex volume measures 4,165 mm³, 1.6% above the reference mean. With a Z-score of 0.11 (54.2th percentile), this represents normal volume ; fusiform gyrus volume measures 18,359 mm³, 2.5% below the reference mean. With a Z-score of -0.22 (41.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,211 mm³, 0.6% below the reference mean. With a Z-score of -0.05 (47.9th percentile), this represents normal volume . ",
  "text_data": "Age is 79.5 years. Gender is Male. Education: 16 years. MMSE: 27.0. MoCA: 21.0. Logical Memory: 12.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volumes (hippocampus, entorhinal cortex, fusiform gyrus, etc.) are within normal ranges, with no significant atrophy. However, the MoCA score (21/30) suggests mild cognitive impairment, while the MMSE (27/30) is borderline normal. The absence of APOE4 reduces Alzheimer's risk but does not rule out other causes of cognitive decline.  \n\n**Diagnosis:** **MCI (Mild Cognitive Impairment)**  \n**Confidence:** **Medium** (due to conflicting MMSE/MoCA results but MoCA’s higher sensitivity for MCI)",
  "timestamp": "2025-07-26T15:53:35.381294"
}