{
  "ptid_time": "094_S_4630_2012-12-04",
  "img_path": "/data/qiuhui/data/adni/images/094_S_4630/2012-12-04/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 18,099 mm³, 19.0% below the reference mean. With a Z-score of -0.47 (31.7th percentile), this represents normal volume ; hippocampal volume measures 6,567 mm³, 14.5% below the reference mean. With a Z-score of -1.63 (5.1th percentile), this represents moderate atrophy; whole brain volume measures 900,724 mm³, 12.5% below the reference mean. With a Z-score of -1.55 (6.0th percentile), this represents moderate atrophy; entorhinal cortex volume measures 3,395 mm³, 12.8% below the reference mean. With a Z-score of -0.99 (16.1th percentile), this represents normal volume ; fusiform gyrus volume measures 15,903 mm³, 12.7% below the reference mean. With a Z-score of -1.43 (7.7th percentile), this represents mild atrophy; middle temporal gyrus volume measures 17,836 mm³, 13.1% below the reference mean. With a Z-score of -1.16 (12.3th percentile), this represents mild atrophy. ",
  "text_data": "Age is 65.9 years. Gender is Female. Education: 16 years. MMSE: 29.0. MoCA: 26.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "Reasoning: The hippocampal and whole brain volumes show moderate atrophy (Z-scores -1.63 and -1.55, respectively), while other regions exhibit mild or normal atrophy. Despite these structural changes, cognitive scores (MMSE 29, MoCA 26) remain within normal limits, suggesting preserved cognitive function. The absence of APOE4 reduces genetic risk but does not rule out neurodegeneration.  \n\nDiagnosis: **Mild Cognitive Impairment (MCI)**  \nConfidence: **Medium** (Cognitive scores are normal, but significant hippocampal/whole brain atrophy raises concern for early neurodegenerative changes.)",
  "timestamp": "2025-07-26T10:32:45.838033"
}