{
  "ptid_time": "009_S_4958_2013-10-21",
  "img_path": "/data/qiuhui/data/adni/images/009_S_4958/2013-10-21/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 79,030 mm³, 105.2% above the reference mean. With a Z-score of 2.52 (99.4th percentile), this represents significant enlargement; hippocampal volume measures 6,485 mm³, 14.2% below the reference mean. With a Z-score of -1.39 (8.3th percentile), this represents mild atrophy; whole brain volume measures 1,007,060 mm³, 6.7% below the reference mean. With a Z-score of -0.87 (19.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,778 mm³, 7.9% below the reference mean. With a Z-score of -0.53 (29.7th percentile), this represents normal volume ; fusiform gyrus volume measures 15,363 mm³, 18.4% below the reference mean. With a Z-score of -1.57 (5.8th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 18,759 mm³, 12.1% below the reference mean. With a Z-score of -1.09 (13.9th percentile), this represents mild atrophy. ",
  "text_data": "Age is 70.5 years. Gender is Male. Education: 20 years. MMSE: 30.0. MoCA: 26.0. Logical Memory: 12.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (suggesting atrophy) and mild-to-moderate atrophy in key Alzheimer’s-related regions (hippocampus, fusiform gyrus, middle temporal gyrus), despite normal cognitive scores (MMSE 30, MoCA 26). The presence of one APOE4 allele increases Alzheimer’s risk.  \n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (structural changes precede clinical symptoms).  \n**Confidence:** **Medium** (imaging strongly suggests neurodegeneration, but cognitive scores are still intact).  \n\n*Note: Given the structural changes, this patient is likely in the preclinical or early MCI stage of Alzheimer’s, but formal dementia diagnosis requires functional decline, which isn’t yet evident.*",
  "timestamp": "2025-07-25T22:25:13.047088"
}