{
  "ptid_time": "126_S_4891_2013-02-19",
  "img_path": "/data/qiuhui/data/adni/images/126_S_4891/2013-02-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 30,931 mm³, 3.0% above the reference mean. With a Z-score of 0.07 (52.9th percentile), this represents normal volume ; hippocampal volume measures 9,190 mm³, 14.5% above the reference mean. With a Z-score of 1.45 (92.6th percentile), this represents mild enlargement; whole brain volume measures 1,238,740 mm³, 9.2% above the reference mean. With a Z-score of 1.30 (90.3th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,560 mm³, 16.5% below the reference mean. With a Z-score of -1.14 (12.7th percentile), this represents mild atrophy; fusiform gyrus volume measures 24,972 mm³, 25.4% above the reference mean. With a Z-score of 2.11 (98.3th percentile), this represents significant enlargement; middle temporal gyrus volume measures 25,494 mm³, 13.8% above the reference mean. With a Z-score of 1.13 (87.1th percentile), this represents mild enlargement. ",
  "text_data": "Age is 60.2 years. Gender is Male. Education: 15 years. MMSE: 30.0. MoCA: 23.0. Laboratory findings: Total Bilirubin: 1.60 (profound elevated); Serum Glucose: 61.00 (significant reduced); Total Protein: 6.20 (significant reduced); Direct Bilirubin: 0.30 (significant elevated). APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows mild atrophy (Z-score -1.14, 12.7th percentile), which is concerning for early neurodegenerative changes, while other regions (hippocampus, whole brain, fusiform gyrus, middle temporal gyrus) show enlargement, possibly compensatory. The MoCA score of 23 suggests mild cognitive impairment (MCI), supported by the APOE4 homozygous status (high genetic risk).  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting volumetric findings—some regions enlarged, some atrophied—but cognitive testing and APOE4 status support MCI).",
  "timestamp": "2025-07-26T12:50:35.212286"
}