{
  "ptid_time": "027_S_4873_2013-12-30",
  "img_path": "/data/qiuhui/data/adni/images/027_S_4873/2013-12-30/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 52,952 mm³, 12.6% above the reference mean. With a Z-score of 0.37 (64.3th percentile), this represents normal volume ; hippocampal volume measures 5,603 mm³, 19.6% below the reference mean. With a Z-score of -1.69 (4.5th percentile), this represents moderate atrophy; whole brain volume measures 1,079,670 mm³, 4.9% above the reference mean. With a Z-score of 0.64 (74.0th percentile), this represents normal volume ; entorhinal cortex volume measures 3,523 mm³, 11.2% below the reference mean. With a Z-score of -0.74 (23.1th percentile), this represents normal volume ; fusiform gyrus volume measures 17,542 mm³, 2.9% below the reference mean. With a Z-score of -0.25 (40.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,292 mm³, 4.4% below the reference mean. With a Z-score of -0.39 (34.8th percentile), this represents normal volume . ",
  "text_data": "Age is 83.6 years. Gender is Male. Education: 12 years. MMSE: 21.0. MoCA: 20.0. Logical Memory: 3.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows moderate atrophy (Z-score -1.69, 4.5th percentile), which is a strong biomarker for Alzheimer's disease. The MMSE (21) and MoCA (20) scores indicate cognitive impairment, but not severe enough for a dementia diagnosis. The absence of APOE4 does not rule out AD, especially given the hippocampal atrophy.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to underlying Alzheimer’s pathology)  \n**Confidence:** **Medium** (due to clear hippocampal atrophy and cognitive deficits, but lack of severe functional impairment typical of dementia)",
  "timestamp": "2025-07-26T04:00:31.893431"
}