{
  "ptid_time": "021_S_2077_2011-10-06",
  "img_path": "/data/qiuhui/data/adni/images/021_S_2077/2011-10-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 40,741 mm³, 13.3% below the reference mean. With a Z-score of -0.39 (34.9th percentile), this represents normal volume ; hippocampal volume measures 8,183 mm³, 17.4% above the reference mean. With a Z-score of 1.51 (93.4th percentile), this represents moderate enlargement; whole brain volume measures 1,239,760 mm³, 20.5% above the reference mean. With a Z-score of 2.68 (99.6th percentile), this represents significant enlargement; entorhinal cortex volume measures 4,430 mm³, 11.6% above the reference mean. With a Z-score of 0.76 (77.6th percentile), this represents normal volume ; fusiform gyrus volume measures 19,121 mm³, 5.8% above the reference mean. With a Z-score of 0.51 (69.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,443 mm³, 6.3% above the reference mean. With a Z-score of 0.56 (71.4th percentile), this represents normal volume . ",
  "text_data": "Age is 82.0 years. Gender is Male. Education: 20 years. Handedness: Right. Race: White. Medical history: Psychiatric; Cardiovascular; Respiratory; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 27.0. MoCA: 21.0. Logical Memory: 14.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volumes show significant enlargement in whole brain and moderate enlargement in the hippocampus, with other regions in the normal range. The MMSE score of 27 is within normal limits, but the MoCA score of 21 suggests mild cognitive impairment (MCI). 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 scores and atypical brain volume patterns)",
  "timestamp": "2025-07-26T01:37:36.412591"
}