{
  "ptid_time": "020_S_4920_2013-10-24",
  "img_path": "/data/qiuhui/data/adni/images/020_S_4920/2013-10-24/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 25,183 mm³, 16.1% below the reference mean. With a Z-score of -0.38 (35.1th percentile), this represents normal volume ; hippocampal volume measures 7,170 mm³, 10.7% below the reference mean. With a Z-score of -1.07 (14.3th percentile), this represents mild atrophy; whole brain volume measures 1,123,900 mm³, 0.9% below the reference mean. With a Z-score of -0.13 (44.7th percentile), this represents normal volume ; entorhinal cortex volume measures 3,235 mm³, 24.1% below the reference mean. With a Z-score of -1.67 (4.8th percentile), this represents moderate atrophy; fusiform gyrus volume measures 19,667 mm³, 1.2% below the reference mean. With a Z-score of -0.10 (46.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,330 mm³, 4.8% below the reference mean. With a Z-score of -0.40 (34.5th percentile), this represents normal volume . ",
  "text_data": "Age is 62.9 years. Gender is Male. Education: 18 years. MMSE: 28.0. MoCA: 24.0. Logical Memory: 3.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows mild hippocampal atrophy (Z-score -1.07, 14.3rd percentile) and moderate entorhinal cortex atrophy (Z-score -1.67, 4.8th percentile), both key regions affected in Alzheimer's disease. Cognitive scores (MMSE 28, MoCA 24) suggest mild cognitive impairment (MCI), particularly given the MoCA score below the typical cutoff of 26. The presence of two APOE4 alleles further increases Alzheimer's risk.  \n\n**Diagnosis:** **MCI** (likely prodromal Alzheimer's disease)  \n**Confidence:** **Medium** (clinical correlation and longitudinal follow-up would strengthen certainty)",
  "timestamp": "2025-07-26T01:14:14.956517"
}