{
  "ptid_time": "082_S_5014_2013-11-21",
  "img_path": "/data/qiuhui/data/adni/images/082_S_5014/2013-11-21/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 61,008 mm³, 58.4% above the reference mean. With a Z-score of 1.40 (91.9th percentile), this represents mild enlargement; hippocampal volume measures 6,127 mm³, 18.9% below the reference mean. With a Z-score of -1.85 (3.2th percentile), this represents moderate atrophy; whole brain volume measures 1,016,890 mm³, 5.8% below the reference mean. With a Z-score of -0.75 (22.6th percentile), this represents normal volume ; entorhinal cortex volume measures 2,973 mm³, 27.5% below the reference mean. With a Z-score of -1.86 (3.1th percentile), this represents moderate atrophy; fusiform gyrus volume measures 14,911 mm³, 20.8% below the reference mean. With a Z-score of -1.78 (3.8th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 18,690 mm³, 12.4% below the reference mean. With a Z-score of -1.12 (13.2th percentile), this represents mild atrophy. ",
  "text_data": "Age is 77.5 years. Gender is Male. Education: 16 years. MMSE: 29.0. MoCA: 24.0. Logical Memory: 8.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in key Alzheimer's-related regions (hippocampus, entorhinal cortex, fusiform gyrus), while cognitive testing reveals a discrepancy between MMSE (normal) and MoCA (mild impairment). The absence of APOE4 reduces genetic risk but does not rule out neurodegeneration.  \n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (High structural evidence of atrophy, but cognitive scores are borderline and lack progression/functional decline data).  \n\n*Note: A follow-up clinical assessment focusing on episodic memory and daily function would strengthen confidence. The MoCA score suggests subtle deficits, while the MMSE may be insensitive to early changes.*",
  "timestamp": "2025-07-26T10:08:27.899753"
}