{
  "ptid_time": "031_S_4029_2012-05-17",
  "img_path": "/data/qiuhui/data/adni/images/031_S_4029/2012-05-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 20,525 mm³, 31.6% below the reference mean. With a Z-score of -0.75 (22.6th percentile), this represents normal volume ; hippocampal volume measures 9,179 mm³, 14.4% above the reference mean. With a Z-score of 1.43 (92.4th percentile), this represents mild enlargement; whole brain volume measures 1,262,820 mm³, 11.3% above the reference mean. With a Z-score of 1.60 (94.5th percentile), this represents moderate enlargement; entorhinal cortex volume measures 4,965 mm³, 16.5% above the reference mean. With a Z-score of 1.14 (87.3th percentile), this represents mild enlargement; fusiform gyrus volume measures 21,255 mm³, 6.8% above the reference mean. With a Z-score of 0.56 (71.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 24,029 mm³, 7.2% above the reference mean. With a Z-score of 0.59 (72.4th percentile), this represents normal volume . ",
  "text_data": "Age is 62.1 years. Gender is Male. Education: 20 years. MMSE: 29.0. MoCA: 25.0. Logical Memory: 13.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows no significant atrophy in key regions typically affected in Alzheimer's disease (AD), such as the hippocampus, entorhinal cortex, and temporal structures—in fact, some volumes are mildly to moderately enlarged. Cognitive scores (MMSE 29, MoCA 25) are within normal limits, though the MoCA is slightly lower than expected for age/education. The presence of two APOE4 alleles increases AD risk but does not confirm pathology without clinical or biomarker evidence.  \n\n**Diagnosis:** **Cognitively Normal (CN)**  \n**Confidence:** **Medium** (due to the discrepancy between MoCA score and volumetric findings, and the high genetic risk, but no clear evidence of neurodegeneration or cognitive impairment).",
  "timestamp": "2025-07-26T04:45:35.771616"
}