{
  "ptid_time": "023_S_0058_2012-04-02",
  "img_path": "/data/qiuhui/data/adni/images/023_S_0058/2012-04-02/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 30,982 mm³, 19.6% below the reference mean. With a Z-score of -0.47 (32.0th percentile), this represents normal volume ; hippocampal volume measures 8,328 mm³, 10.2% above the reference mean. With a Z-score of 0.99 (83.9th percentile), this represents normal volume ; whole brain volume measures 967,472 mm³, 10.4% below the reference mean. With a Z-score of -1.35 (8.9th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,856 mm³, 6.0% below the reference mean. With a Z-score of -0.40 (34.3th percentile), this represents normal volume ; fusiform gyrus volume measures 15,988 mm³, 15.1% below the reference mean. With a Z-score of -1.29 (9.9th percentile), this represents mild atrophy; middle temporal gyrus volume measures 20,430 mm³, 4.3% below the reference mean. With a Z-score of -0.38 (35.1th percentile), this represents normal volume . ",
  "text_data": "Age is 76.1 years. Gender is Male. Education: 16 years. MMSE: 29.0. MoCA: 22.0. Logical Memory: 17.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain imaging shows mild atrophy in the whole brain and fusiform gyrus, but other key regions (hippocampus, entorhinal cortex, middle temporal gyrus) are within normal ranges. The MMSE score is normal (29/30), but the MoCA score (22/30) suggests mild cognitive impairment (MCI). The presence of one APOE4 allele increases Alzheimer's risk but does not confirm dementia.  \n\n**Diagnosis:** **MCI** (Mild Cognitive Impairment)  \n**Confidence:** **Medium** (due to conflicting MoCA and MMSE scores, and only mild atrophy in select regions)",
  "timestamp": "2025-07-26T02:30:37.752140"
}