{
  "ptid_time": "027_S_2245_2014-01-13",
  "img_path": "/data/qiuhui/data/adni/images/027_S_2245/2014-01-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 17,436 mm³, 21.9% below the reference mean. With a Z-score of -0.55 (29.1th percentile), this represents normal volume ; hippocampal volume measures 8,531 mm³, 11.0% above the reference mean. With a Z-score of 1.24 (89.2th percentile), this represents mild enlargement; whole brain volume measures 1,021,810 mm³, 0.7% below the reference mean. With a Z-score of -0.09 (46.5th percentile), this represents normal volume ; entorhinal cortex volume measures 3,989 mm³, 2.5% above the reference mean. With a Z-score of 0.19 (57.6th percentile), this represents normal volume ; fusiform gyrus volume measures 18,119 mm³, 0.5% below the reference mean. With a Z-score of -0.06 (47.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,372 mm³, 4.2% above the reference mean. With a Z-score of 0.37 (64.4th percentile), this represents normal volume . ",
  "text_data": "Age is 60.0 years. Gender is Female. Education: 20 years. MMSE: 28.0. MoCA: 24.0. Logical Memory: 7.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are largely within normal ranges, with mild hippocampal enlargement (uncommon in Alzheimer's but not diagnostic). Cognitive scores (MMSE 28, MoCA 24) suggest mild cognitive concern (MoCA <26 is typical for MCI), but structural imaging does not show atrophy typical of Alzheimer’s. APOE4 homozygosity (2 alleles) increases Alzheimer’s risk but is not diagnostic.  \n**Diagnosis:** **MCI** (Mild Cognitive Impairment)  \n**Confidence:** **Medium** (MoCA supports MCI, but imaging lacks typical Alzheimer’s atrophy; APOE4 raises suspicion but isn’t conclusive).  \n\n*Note: Clinical correlation (e.g., neuropsychological testing, CSF biomarkers, or FDG-PET) would strengthen confidence.*",
  "timestamp": "2025-07-26T03:54:38.817294"
}