{
  "ptid_time": "057_S_1269_2012-02-08",
  "img_path": "/data/qiuhui/data/adni/images/057_S_1269/2012-02-08/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 49,253 mm³, 27.9% above the reference mean. With a Z-score of 0.67 (74.8th percentile), this represents normal volume ; hippocampal volume measures 6,757 mm³, 10.6% below the reference mean. With a Z-score of -1.04 (15.0th percentile), this represents mild atrophy; whole brain volume measures 1,004,890 mm³, 6.9% below the reference mean. With a Z-score of -0.90 (18.5th percentile), this represents normal volume ; entorhinal cortex volume measures 4,279 mm³, 4.4% above the reference mean. With a Z-score of 0.30 (61.6th percentile), this represents normal volume ; fusiform gyrus volume measures 16,909 mm³, 10.2% below the reference mean. With a Z-score of -0.87 (19.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,657 mm³, 1.5% above the reference mean. With a Z-score of 0.13 (55.3th percentile), this represents normal volume . ",
  "text_data": "Age is 78.4 years. Gender is Male. Education: 20 years. Handedness: Unknown. Race: Unknown. MMSE: 29.0. MoCA: 22.0. Logical Memory: 14.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.04, 15th percentile), which is a key biomarker for Alzheimer's pathology, while other brain regions are within normal ranges. The MoCA score (22/30) suggests mild cognitive impairment, whereas the MMSE (29/30) is near-normal, indicating possible early-stage cognitive decline. The absence of APOE4 reduces genetic risk but does not rule out neurodegeneration.  \n\n**Diagnosis:** **MCI (Mild Cognitive Impairment)**  \n**Confidence:** **Medium** (due to hippocampal atrophy and MoCA score, but MMSE is near-normal and APOE4-negative)",
  "timestamp": "2025-07-26T08:11:24.633614"
}