{
  "ptid_time": "068_S_2193_2012-05-07",
  "img_path": "/data/qiuhui/data/adni/images/068_S_2193/2012-05-07/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 38,280 mm³, 0.6% below the reference mean. With a Z-score of -0.01 (49.4th percentile), this represents normal volume ; hippocampal volume measures 4,564 mm³, 39.6% below the reference mean. With a Z-score of -3.87 (0.0th percentile), this represents profound atrophy; whole brain volume measures 932,501 mm³, 13.6% below the reference mean. With a Z-score of -1.77 (3.9th percentile), this represents moderate atrophy; entorhinal cortex volume measures 3,102 mm³, 24.4% below the reference mean. With a Z-score of -1.65 (4.9th percentile), this represents moderate atrophy; fusiform gyrus volume measures 15,664 mm³, 16.9% below the reference mean. With a Z-score of -1.44 (7.6th percentile), this represents mild atrophy; middle temporal gyrus volume measures 19,925 mm³, 6.6% below the reference mean. With a Z-score of -0.60 (27.6th percentile), this represents normal volume . ",
  "text_data": "Age is 76.5 years. Gender is Male. Education: 19 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Malignancy; Major Surgical Procedures. MMSE: 29.0. MoCA: 22.0. Logical Memory: 7.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows profound atrophy (Z-score -3.87, 0.0th percentile), which is highly suggestive of Alzheimer's pathology. The whole brain, entorhinal cortex, and fusiform gyrus also show mild to moderate atrophy, while ventricular volume and middle temporal gyrus are normal. Despite the high MMSE (29), the MoCA (22) indicates mild cognitive impairment, and the absence of APOE4 does not rule out AD.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**, likely due to Alzheimer's disease.  \n\n**Confidence:** **High** (due to significant hippocampal atrophy and cognitive testing results).",
  "timestamp": "2025-07-26T08:56:06.622964"
}