{
  "ptid_time": "036_S_5283_2016-08-23",
  "img_path": "/data/qiuhui/data/adni/images/036_S_5283/2016-08-23/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 24,543 mm³, 12.6% below the reference mean. With a Z-score of -0.29 (38.7th percentile), this represents normal volume ; hippocampal volume measures 6,708 mm³, 5.7% below the reference mean. With a Z-score of -0.52 (30.0th percentile), this represents normal volume ; whole brain volume measures 989,772 mm³, 1.6% above the reference mean. With a Z-score of 0.20 (57.7th percentile), this represents normal volume ; entorhinal cortex volume measures 3,536 mm³, 3.7% below the reference mean. With a Z-score of -0.23 (41.0th percentile), this represents normal volume ; fusiform gyrus volume measures 19,167 mm³, 12.7% above the reference mean. With a Z-score of 1.15 (87.5th percentile), this represents mild enlargement; middle temporal gyrus volume measures 19,850 mm³, 3.6% above the reference mean. With a Z-score of 0.31 (62.1th percentile), this represents normal volume . ",
  "text_data": "Age is 75.9 years. Gender is Female. Education: 16 years. MMSE: 27.0. MoCA: 23.0. Logical Memory: 14.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are largely within normal ranges, with only mild deviations (e.g., fusiform gyrus enlargement, which is not typically associated with Alzheimer's pathology). The MMSE score of 27 is normal, but the MoCA score of 23 suggests mild cognitive impairment (MCI). The presence of one APOE4 allele increases Alzheimer's risk but does not confirm pathology.  \n\n**Diagnosis:** **MCI** (Mild Cognitive Impairment)  \n**Confidence:** **Medium** (due to borderline MoCA score and normal imaging, but APOE4 adds some concern)",
  "timestamp": "2025-07-26T06:21:41.265597"
}