{
  "ptid_time": "126_S_4458_2012-07-31",
  "img_path": "/data/qiuhui/data/adni/images/126_S_4458/2012-07-31/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 42,366 mm³, 50.9% above the reference mean. With a Z-score of 1.17 (87.8th percentile), this represents mild enlargement; hippocampal volume measures 6,355 mm³, 10.7% below the reference mean. With a Z-score of -0.98 (16.4th percentile), this represents normal volume ; whole brain volume measures 972,892 mm³, 0.2% below the reference mean. With a Z-score of -0.02 (49.1th percentile), this represents normal volume ; entorhinal cortex volume measures 2,778 mm³, 24.4% below the reference mean. With a Z-score of -1.50 (6.7th percentile), this represents mild atrophy; fusiform gyrus volume measures 15,290 mm³, 10.1% below the reference mean. With a Z-score of -0.92 (17.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,017 mm³, 11.2% below the reference mean. With a Z-score of -0.97 (16.5th percentile), this represents normal volume . ",
  "text_data": "Age is 76.6 years. Gender is Female. Education: 16 years. MMSE: 27.0. MoCA: 15.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows mild ventricular enlargement and mild entorhinal cortex atrophy, while hippocampal and other regional volumes are within normal ranges. The MMSE score of 27 is normal, but the MoCA score of 15 suggests significant cognitive impairment, which is inconsistent with the MMSE and may indicate a need for further evaluation. The presence of one APOE4 allele increases Alzheimer's risk but is not diagnostic.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (given the MoCA score discrepancy and mild structural changes, but not meeting full dementia criteria).  \n\n**Confidence:** **Medium** (due to conflicting cognitive scores and only mild structural abnormalities).",
  "timestamp": "2025-07-26T12:45:31.191105"
}