{
  "ptid_time": "031_S_4149_2012-08-31",
  "img_path": "/data/qiuhui/data/adni/images/031_S_4149/2012-08-31/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 35,221 mm³, 8.6% below the reference mean. With a Z-score of -0.21 (41.9th percentile), this represents normal volume ; whole brain volume measures 1,154,160 mm³, 6.9% above the reference mean. With a Z-score of 0.90 (81.6th percentile), this represents normal volume ; entorhinal cortex volume measures 3,748 mm³, 8.6% below the reference mean. With a Z-score of -0.58 (28.0th percentile), this represents normal volume ; fusiform gyrus volume measures 15,491 mm³, 17.8% below the reference mean. With a Z-score of -1.51 (6.5th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 20,488 mm³, 4.0% below the reference mean. With a Z-score of -0.36 (36.0th percentile), this represents normal volume . ",
  "text_data": "Age is 74.3 years. Gender is Male. Education: 14 years. MMSE: 28.0. MoCA: 21.0. Logical Memory: 7.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "Reasoning: The fusiform gyrus shows moderate atrophy (Z-score -1.51, 6.5th percentile), which is concerning for early neurodegenerative changes. However, other brain regions (ventricular, whole brain, entorhinal cortex, middle temporal gyrus) are within normal ranges. The MMSE is normal (28/30), but the MoCA (21/30) suggests mild cognitive impairment, particularly in executive function or visuospatial domains. APOE4 carrier status increases Alzheimer's risk.  \n\nDiagnosis: **MCI (Mild Cognitive Impairment)**  \nConfidence: **Medium** (MoCA supports MCI, but MMSE is normal; fusiform atrophy is notable but not widespread)",
  "timestamp": "2025-07-26T04:47:12.374843"
}