{
  "ptid_time": "013_S_2324_2012-04-17",
  "img_path": "/data/qiuhui/data/adni/images/013_S_2324/2012-04-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 12,146 mm³, 34.8% below the reference mean. With a Z-score of -1.00 (16.0th percentile), this represents normal volume ; hippocampal volume measures 7,664 mm³, 1.8% below the reference mean. With a Z-score of -0.26 (39.9th percentile), this represents normal volume ; whole brain volume measures 959,297 mm³, 7.8% below the reference mean. With a Z-score of -0.94 (17.5th percentile), this represents normal volume ; entorhinal cortex volume measures 3,825 mm³, 3.5% above the reference mean. With a Z-score of 0.27 (60.8th percentile), this represents normal volume ; fusiform gyrus volume measures 19,212 mm³, 4.2% above the reference mean. With a Z-score of 0.38 (65.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,080 mm³, 11.9% below the reference mean. With a Z-score of -0.99 (16.2th percentile), this represents normal volume . ",
  "text_data": "Age is 57.3 years. Gender is Female. Education: 13 years. Handedness: Right. Race: Unknown. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Gastrointestinal; Smoking; Major Surgical Procedures. MMSE: 30.0. MoCA: 22.0. Logical Memory: 9.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements (hippocampus, entorhinal cortex, fusiform gyrus, etc.) are within normal ranges (Z-scores close to 0, percentiles near 50th). However, the MoCA score of 22 suggests mild cognitive impairment (MCI), while the MMSE of 30 is normal, creating a discrepancy. The presence of one APOE4 allele increases Alzheimer’s risk but is not diagnostic.  \n\n**Diagnosis:** **MCI** (due to MoCA score indicating cognitive decline despite normal imaging and MMSE).  \n\n**Confidence:** **Medium** (imaging is normal, but MoCA suggests impairment; clinical correlation is needed to rule out other causes of low MoCA).",
  "timestamp": "2025-07-25T23:29:17.486180"
}