{
  "ptid_time": "073_S_2264_2014-03-06",
  "img_path": "/data/qiuhui/data/adni/images/073_S_2264/2014-03-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 55,834 mm³, 45.0% above the reference mean. With a Z-score of 1.08 (85.9th percentile), this represents mild enlargement; hippocampal volume measures 7,680 mm³, 1.6% above the reference mean. With a Z-score of 0.16 (56.2th percentile), this represents normal volume ; whole brain volume measures 1,149,370 mm³, 6.5% above the reference mean. With a Z-score of 0.84 (80.0th percentile), this represents normal volume ; entorhinal cortex volume measures 4,305 mm³, 5.0% above the reference mean. With a Z-score of 0.34 (63.2th percentile), this represents normal volume ; fusiform gyrus volume measures 18,607 mm³, 1.2% below the reference mean. With a Z-score of -0.10 (45.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,845 mm³, 2.4% above the reference mean. With a Z-score of 0.21 (58.4th percentile), this represents normal volume . ",
  "text_data": "Age is 72.3 years. Gender is Male. Education: 18 years. MMSE: 27.0. MoCA: 21.0. Logical Memory: 15.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The ventricular volume shows mild enlargement (Z-score 1.08), which can be associated with atrophy, but hippocampal and other key regional volumes (entorhinal cortex, fusiform gyrus, middle temporal gyrus) are within normal ranges. The MMSE (27/30) is normal, but the MoCA (21/30) suggests mild cognitive impairment, particularly in executive/attention domains. APOE4 carrier status increases Alzheimer’s risk but is not diagnostic.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (MoCA supports MCI, but structural changes are mild and not strongly localized to Alzheimer’s-vulnerable regions).",
  "timestamp": "2025-07-26T09:40:06.060466"
}