{
  "ptid_time": "037_S_0454_2014-04-16",
  "img_path": "/data/qiuhui/data/adni/images/037_S_0454/2014-04-16/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 43,646 mm³, 18.1% above the reference mean. With a Z-score of 0.49 (68.7th percentile), this represents normal volume ; hippocampal volume measures 6,375 mm³, 1.8% below the reference mean. With a Z-score of -0.15 (44.1th percentile), this represents normal volume ; whole brain volume measures 964,831 mm³, 3.9% above the reference mean. With a Z-score of 0.47 (68.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,469 mm³, 0.2% above the reference mean. With a Z-score of 0.01 (50.4th percentile), this represents normal volume ; fusiform gyrus volume measures 14,963 mm³, 7.1% below the reference mean. With a Z-score of -0.54 (29.6th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,802 mm³, 6.8% below the reference mean. With a Z-score of -0.61 (27.2th percentile), this represents normal volume . ",
  "text_data": "Age is 89.8 years. Gender is Female. Education: 13 years. MMSE: 29.0. MoCA: 23.0. Logical Memory: 15.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are all within normal ranges (Z-scores close to 0, percentiles near 50th), with no significant atrophy in key regions like the hippocampus or entorhinal cortex. The MMSE score of 29 is normal, but the MoCA score of 23 suggests mild cognitive impairment (MCI), though this could be influenced by age (89.8 years) or other non-neurodegenerative factors. The absence of APOE4 reduces Alzheimer's risk.  \n\n**Diagnosis:** MCI  \n**Confidence:** Medium (due to the discrepancy between MMSE and MoCA, and normal imaging despite cognitive screening suggesting impairment)",
  "timestamp": "2025-07-26T06:28:59.399878"
}