{
  "ptid_time": "013_S_4268_2012-11-15",
  "img_path": "/data/qiuhui/data/adni/images/013_S_4268/2012-11-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 20,101 mm³, 10.0% below the reference mean. With a Z-score of -0.25 (40.1th percentile), this represents normal volume ; hippocampal volume measures 7,621 mm³, 0.8% below the reference mean. With a Z-score of -0.09 (46.3th percentile), this represents normal volume ; whole brain volume measures 1,019,900 mm³, 0.9% below the reference mean. With a Z-score of -0.11 (45.5th percentile), this represents normal volume ; entorhinal cortex volume measures 3,654 mm³, 6.1% below the reference mean. With a Z-score of -0.48 (31.7th percentile), this represents normal volume ; fusiform gyrus volume measures 16,915 mm³, 7.1% below the reference mean. With a Z-score of -0.80 (21.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,774 mm³, 13.4% below the reference mean. With a Z-score of -1.19 (11.7th percentile), this represents mild atrophy. ",
  "text_data": "Age is 64.5 years. Gender is Female. Education: 15 years. MMSE: 30.0. MoCA: 22.0. Logical Memory: 10.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are largely within normal ranges, with only mild atrophy noted in the middle temporal gyrus (Z-score -1.19, 11.7th percentile). The MMSE score of 30 is normal, but the MoCA score of 22 suggests possible mild cognitive impairment (MCI). The absence of APOE4 reduces genetic risk for Alzheimer’s.  \n\n**Diagnosis:** **MCI** (due to MoCA score indicating cognitive decline despite normal MMSE and mostly normal brain volumes).  \n\n**Confidence:** **Medium** (MoCA is concerning, but structural changes are mild and APOE4-negative status lowers Alzheimer’s risk).",
  "timestamp": "2025-07-25T23:30:44.996449"
}