{
  "ptid_time": "016_S_0359_2010-11-04",
  "img_path": "/data/qiuhui/data/adni/images/016_S_0359/2010-11-04/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 34,286 mm³, 7.2% below the reference mean. With a Z-score of -0.20 (42.2th percentile), this represents normal volume ; hippocampal volume measures 6,456 mm³, 0.6% below the reference mean. With a Z-score of -0.05 (48.1th percentile), this represents normal volume ; whole brain volume measures 762,520 mm³, 17.8% below the reference mean. With a Z-score of -2.14 (1.6th percentile), this represents significant atrophy; entorhinal cortex volume measures 3,087 mm³, 10.8% below the reference mean. With a Z-score of -0.59 (27.9th percentile), this represents normal volume ; fusiform gyrus volume measures 15,779 mm³, 2.1% below the reference mean. With a Z-score of -0.15 (43.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 13,952 mm³, 22.6% below the reference mean. With a Z-score of -2.01 (2.2th percentile), this represents significant atrophy. ",
  "text_data": "Age is 85.3 years. Gender is Female. Education: 14 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Endocrine-Metabolic; Gastrointestinal; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 29.0. MoCA: 26.0. Logical Memory: 15.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in whole brain volume (Z-score -2.14, 1.6th percentile) and middle temporal gyrus (Z-score -2.01, 2.2nd percentile), which are concerning for neurodegeneration. However, hippocampal and entorhinal cortex volumes are within normal limits, and cognitive scores (MMSE 29, MoCA 26) are intact, suggesting no functional impairment.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (structural changes without significant cognitive decline)  \n**Confidence:** **Medium** (due to conflicting findings—severe atrophy in some regions but preserved cognition and key memory-related structures)",
  "timestamp": "2025-07-26T00:01:49.340110"
}