{
  "ptid_time": "168_S_6817_2019-10-03",
  "img_path": "/data/qiuhui/data/adni/images/168_S_6817/2019-10-03/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 34,024 mm³, 13.3% above the reference mean. With a Z-score of 0.32 (62.4th percentile), this represents normal volume ; hippocampal volume measures 7,710 mm³, 4.0% below the reference mean. With a Z-score of -0.40 (34.6th percentile), this represents normal volume ; whole brain volume measures 1,020,270 mm³, 10.1% below the reference mean. With a Z-score of -1.43 (7.7th percentile), this represents mild atrophy; entorhinal cortex volume measures 4,099 mm³, 3.8% below the reference mean. With a Z-score of -0.27 (39.5th percentile), this represents normal volume ; fusiform gyrus volume measures 20,500 mm³, 3.0% above the reference mean. With a Z-score of 0.25 (59.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,955 mm³, 2.4% above the reference mean. With a Z-score of 0.20 (57.9th percentile), this represents normal volume . ",
  "text_data": "Age is 66.1 years. Gender is Male. Education: 18 years. MMSE: 24.0. MoCA: 19.0. Logical Memory: 6.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows mild whole brain atrophy (Z-score -1.43, 7.7th percentile) but otherwise normal hippocampal, entorhinal, and other regional volumes. Cognitive testing reveals mild impairment (MMSE 24, MoCA 19), which is below typical thresholds for normal cognition but not severe enough for dementia. The presence of one APOE4 allele increases Alzheimer's risk but is not definitive.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Cognitive scores suggest impairment, but structural changes are not severe enough for dementia. APOE4 supports but does not confirm neurodegenerative pathology.)",
  "timestamp": "2025-07-26T17:23:04.750046"
}