{
  "ptid_time": "094_S_4560_2013-03-21",
  "img_path": "/data/qiuhui/data/adni/images/094_S_4560/2013-03-21/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 27,246 mm³, 2.9% below the reference mean. With a Z-score of -0.07 (47.3th percentile), this represents normal volume ; hippocampal volume measures 5,577 mm³, 21.6% below the reference mean. With a Z-score of -1.98 (2.4th percentile), this represents moderate atrophy; whole brain volume measures 911,278 mm³, 6.5% below the reference mean. With a Z-score of -0.82 (20.7th percentile), this represents normal volume ; entorhinal cortex volume measures 4,061 mm³, 10.6% above the reference mean. With a Z-score of 0.65 (74.2th percentile), this represents normal volume ; fusiform gyrus volume measures 19,137 mm³, 12.5% above the reference mean. With a Z-score of 1.14 (87.2th percentile), this represents mild enlargement; middle temporal gyrus volume measures 16,793 mm³, 12.4% below the reference mean. With a Z-score of -1.08 (14.1th percentile), this represents mild atrophy. ",
  "text_data": "Age is 71.3 years. Gender is Female. Education: 20 years. MMSE: 30.0. MoCA: 26.0. Logical Memory: 16.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows moderate atrophy (Z-score -1.98, 2.4th percentile), which is a strong biomarker for Alzheimer's pathology, while other regions are largely normal or mildly affected. Cognitive scores (MMSE 30, MoCA 26) are borderline for MCI (MoCA <26 often suggests MCI), but the preserved MMSE complicates the picture. APOE4-negative status reduces genetic risk but doesn't rule out AD.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Hippocampal atrophy strongly suggests neurodegeneration, but cognitive scores are not definitively impaired; clinical correlation needed for functional impact).",
  "timestamp": "2025-07-26T10:32:23.091528"
}