{
  "ptid_time": "007_S_4620_2018-12-11",
  "img_path": "/data/qiuhui/data/adni/images/007_S_4620/2018-12-11/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 54,904 mm³, 16.8% above the reference mean. With a Z-score of 0.49 (68.7th percentile), this represents normal volume ; hippocampal volume measures 6,082 mm³, 12.7% below the reference mean. With a Z-score of -1.10 (13.6th percentile), this represents mild atrophy; whole brain volume measures 947,373 mm³, 7.9% below the reference mean. With a Z-score of -1.04 (14.9th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,092 mm³, 22.1% below the reference mean. With a Z-score of -1.45 (7.4th percentile), this represents mild atrophy; fusiform gyrus volume measures 17,861 mm³, 1.1% below the reference mean. With a Z-score of -0.10 (46.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,094 mm³, 0.4% below the reference mean. With a Z-score of -0.03 (48.6th percentile), this represents normal volume . ",
  "text_data": "Age is 83.6 years. Gender is Male. Education: 19 years. MMSE: 30.0. MoCA: 24.0. Logical Memory: 12.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal, whole brain, and entorhinal cortex volumes show mild atrophy (Z-scores between -1.04 and -1.45), which is concerning for early neurodegenerative changes. However, cognitive testing (MMSE 30, MoCA 24) does not indicate significant impairment, though the MoCA score is borderline for MCI. The absence of APOE4 reduces genetic risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (structural atrophy is present, but cognitive scores are not strongly impaired; clinical correlation needed for definitive diagnosis).",
  "timestamp": "2025-07-25T22:05:08.661097"
}