{
  "ptid_time": "037_S_4706_2012-11-05",
  "img_path": "/data/qiuhui/data/adni/images/037_S_4706/2012-11-05/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 18,675 mm³, 37.8% below the reference mean. With a Z-score of -0.90 (18.5th percentile), this represents normal volume ; hippocampal volume measures 7,881 mm³, 1.8% below the reference mean. With a Z-score of -0.18 (42.8th percentile), this represents normal volume ; whole brain volume measures 1,072,880 mm³, 5.4% below the reference mean. With a Z-score of -0.77 (22.1th percentile), this represents normal volume ; entorhinal cortex volume measures 3,707 mm³, 13.0% below the reference mean. With a Z-score of -0.90 (18.3th percentile), this represents normal volume ; fusiform gyrus volume measures 19,178 mm³, 3.7% below the reference mean. With a Z-score of -0.31 (38.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,969 mm³, 2.0% below the reference mean. With a Z-score of -0.16 (43.5th percentile), this represents normal volume . ",
  "text_data": "Age is 61.2 years. Gender is Male. Education: 14 years. MMSE: 28.0. MoCA: 18.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements (ventricular, hippocampal, whole brain, entorhinal cortex, fusiform gyrus, and middle temporal gyrus) are all within normal ranges (Z-scores between -0.18 and -0.90, percentiles 18.3–43.5). However, the MoCA score of 18 is below the typical cutoff for normal cognition (≥26), suggesting possible cognitive impairment, while the MMSE score of 28 is borderline normal (≥24). The presence of one APOE4 allele increases Alzheimer's risk but is not diagnostic.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to the discrepancy between MoCA and MMSE, normal brain volumes, and lack of progression/functional decline data).",
  "timestamp": "2025-07-26T06:47:11.600253"
}