{
  "ptid_time": "006_S_4713_2013-06-12",
  "img_path": "/data/qiuhui/data/adni/images/006_S_4713/2013-06-12/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 24,810 mm³, 35.6% below the reference mean. With a Z-score of -0.85 (19.7th percentile), this represents normal volume ; hippocampal volume measures 9,695 mm³, 28.3% above the reference mean. With a Z-score of 2.76 (99.7th percentile), this represents significant enlargement; whole brain volume measures 1,172,500 mm³, 8.6% above the reference mean. With a Z-score of 1.12 (86.9th percentile), this represents mild enlargement; entorhinal cortex volume measures 5,934 mm³, 44.7% above the reference mean. With a Z-score of 3.03 (99.9th percentile), this represents profound enlargement; fusiform gyrus volume measures 19,162 mm³, 1.7% above the reference mean. With a Z-score of 0.15 (55.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 23,795 mm³, 11.5% above the reference mean. With a Z-score of 1.03 (85.0th percentile), this represents mild enlargement. ",
  "text_data": "Age is 71.5 years. Gender is Male. Education: 20 years. MMSE: 30.0. MoCA: 26.0. Logical Memory: 10.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows significant enlargement in the hippocampus, entorhinal cortex, and mild enlargement in the whole brain and middle temporal gyrus—unusual for Alzheimer’s, which typically involves atrophy. Cognitive scores (MMSE 30, MoCA 26) are within normal to mild concern range, and APOE4 status (heterozygous) slightly increases AD risk but does not explain the volumetric findings.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (Volumetric findings are atypical for neurodegeneration, but MoCA score suggests mild cognitive monitoring may be warranted.)",
  "timestamp": "2025-07-25T21:40:45.679579"
}