{
  "ptid_time": "127_S_5132_2020-09-28",
  "img_path": "/data/qiuhui/data/adni/images/127_S_5132/2020-09-28/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 23,928 mm³, 14.8% below the reference mean. With a Z-score of -0.34 (36.8th percentile), this represents normal volume ; hippocampal volume measures 6,942 mm³, 2.4% below the reference mean. With a Z-score of -0.22 (41.2th percentile), this represents normal volume ; whole brain volume measures 960,675 mm³, 1.4% below the reference mean. With a Z-score of -0.18 (42.8th percentile), this represents normal volume ; entorhinal cortex volume measures 3,619 mm³, 1.5% below the reference mean. With a Z-score of -0.09 (46.4th percentile), this represents normal volume ; fusiform gyrus volume measures 18,417 mm³, 8.3% above the reference mean. With a Z-score of 0.75 (77.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,869 mm³, 1.6% below the reference mean. With a Z-score of -0.14 (44.6th percentile), this represents normal volume . ",
  "text_data": "Age is 76.8 years. Gender is Female. Education: 12 years. MMSE: 27.0. MoCA: 22.0. Logical Memory: 4.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** All brain volumes (ventricular, hippocampal, whole brain, entorhinal cortex, fusiform gyrus, and middle temporal gyrus) are within normal ranges based on Z-scores and percentiles. The MMSE score of 27 is within the normal range, but the MoCA score of 22 suggests mild cognitive impairment (MCI). The absence of APOE4 reduces genetic risk for Alzheimer's.  \n\n**Diagnosis:** MCI  \n**Confidence:** Medium  \n\n*(Confidence is medium because while MoCA suggests MCI, structural brain volumes are normal, and MMSE is borderline normal. Further clinical correlation may be needed.)*",
  "timestamp": "2025-07-26T13:26:56.317843"
}