{
  "ptid_time": "012_S_4188_2012-09-18",
  "img_path": "/data/qiuhui/data/adni/images/012_S_4188/2012-09-18/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 50,837 mm³, 32.0% above the reference mean. With a Z-score of 0.77 (77.8th percentile), this represents normal volume ; hippocampal volume measures 6,612 mm³, 12.5% below the reference mean. With a Z-score of -1.22 (11.1th percentile), this represents mild atrophy; whole brain volume measures 1,102,580 mm³, 2.1% above the reference mean. With a Z-score of 0.28 (61.0th percentile), this represents normal volume ; entorhinal cortex volume measures 2,789 mm³, 32.0% below the reference mean. With a Z-score of -2.17 (1.5th percentile), this represents significant atrophy; fusiform gyrus volume measures 17,395 mm³, 7.7% below the reference mean. With a Z-score of -0.65 (25.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,990 mm³, 1.6% below the reference mean. With a Z-score of -0.15 (44.2th percentile), this represents normal volume . ",
  "text_data": "Age is 78.2 years. Gender is Male. Education: 14 years. MMSE: 25.0. MoCA: 19.0. Logical Memory: 1.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in the entorhinal cortex (Z-score -2.17, 1.5th percentile) and mild hippocampal atrophy (Z-score -1.22, 11.1th percentile), both key regions in Alzheimer's pathology. Cognitive testing (MMSE 25, MoCA 19) suggests mild impairment, consistent with MCI. The presence of one APOE4 allele further supports increased Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to borderline cognitive scores and significant entorhinal atrophy, but lack of widespread cortical atrophy or severe cognitive decline)",
  "timestamp": "2025-07-25T23:13:41.797826"
}