{
  "ptid_time": "023_S_4241_2013-03-25",
  "img_path": "/data/qiuhui/data/adni/images/023_S_4241/2013-03-25/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 39,672 mm³, 41.3% above the reference mean. With a Z-score of 0.95 (82.8th percentile), this represents normal volume ; hippocampal volume measures 6,951 mm³, 2.3% below the reference mean. With a Z-score of -0.21 (41.7th percentile), this represents normal volume ; whole brain volume measures 1,079,290 mm³, 10.7% above the reference mean. With a Z-score of 1.35 (91.2th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,468 mm³, 5.6% below the reference mean. With a Z-score of -0.34 (36.6th percentile), this represents normal volume ; fusiform gyrus volume measures 19,902 mm³, 17.0% above the reference mean. With a Z-score of 1.55 (93.9th percentile), this represents moderate enlargement; middle temporal gyrus volume measures 20,245 mm³, 5.6% above the reference mean. With a Z-score of 0.49 (68.7th percentile), this represents normal volume . ",
  "text_data": "Age is 70.8 years. Gender is Female. Education: 18 years. MMSE: 27.0. MoCA: 21.0. Logical Memory: 8.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are largely within normal ranges, with only mild deviations (e.g., slightly reduced hippocampal and entorhinal cortex volumes). However, the MoCA score of 21 suggests mild cognitive impairment, while the MMSE of 27 is borderline normal. The absence of APOE4 reduces Alzheimer's risk but does not rule out other causes of cognitive decline.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting MMSE/MoCA results and mostly normal imaging, but MoCA strongly suggests MCI).",
  "timestamp": "2025-07-26T03:04:42.185235"
}