{
  "ptid_time": "126_S_4896_2013-08-15",
  "img_path": "/data/qiuhui/data/adni/images/126_S_4896/2013-08-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 35,977 mm³, 19.8% above the reference mean. With a Z-score of 0.47 (68.1th percentile), this represents normal volume ; hippocampal volume measures 7,691 mm³, 4.2% below the reference mean. With a Z-score of -0.42 (33.8th percentile), this represents normal volume ; whole brain volume measures 1,220,740 mm³, 7.6% above the reference mean. With a Z-score of 1.08 (85.9th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,985 mm³, 6.5% below the reference mean. With a Z-score of -0.45 (32.6th percentile), this represents normal volume ; fusiform gyrus volume measures 20,298 mm³, 2.0% above the reference mean. With a Z-score of 0.16 (56.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,252 mm³, 0.7% below the reference mean. With a Z-score of -0.06 (47.7th percentile), this represents normal volume . ",
  "text_data": "Age is 69.1 years. Gender is Male. Education: 12 years. MMSE: 26.0. MoCA: 20.0. Logical Memory: 4.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal and entorhinal cortex volumes are slightly below the reference mean but still within the normal range (Z-scores -0.42 and -0.45, respectively). The MMSE score of 26 is borderline (mild cognitive impairment range starts around 24-26), while the MoCA score of 20 is below the typical cutoff of 26 for normal cognition, suggesting possible cognitive impairment. 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 yet strongly indicative of dementia.)",
  "timestamp": "2025-07-26T12:51:45.573457"
}