{
  "ptid_time": "021_S_4659_2014-04-17",
  "img_path": "/data/qiuhui/data/adni/images/021_S_4659/2014-04-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 59,398 mm³, 26.3% above the reference mean. With a Z-score of 0.76 (77.8th percentile), this represents normal volume ; hippocampal volume measures 7,015 mm³, 0.7% above the reference mean. With a Z-score of 0.06 (52.3th percentile), this represents normal volume ; whole brain volume measures 1,143,700 mm³, 11.1% above the reference mean. With a Z-score of 1.46 (92.8th percentile), this represents mild enlargement. ",
  "text_data": "Age is 87.9 years. Gender is Male. Education: 17 years. MMSE: 27.0. MoCA: 21.0. Logical Memory: 5.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volumes (ventricular, hippocampal, and whole brain) are within normal ranges or mildly enlarged, suggesting no significant atrophy. However, the MoCA score of 21/30 indicates mild cognitive impairment, while the MMSE of 27/30 is borderline normal. The presence of two APOE4 alleles increases Alzheimer's risk, but structural imaging does not yet show clear neurodegeneration.  \n\n**Diagnosis:** **MCI (Mild Cognitive Impairment)**  \n**Confidence:** **Medium** (Cognitive testing suggests impairment, but imaging does not yet support dementia-level neurodegeneration.)",
  "timestamp": "2025-07-26T01:49:55.560199"
}