{
  "ptid_time": "099_S_2205_2011-06-16",
  "img_path": "/data/qiuhui/data/adni/images/099_S_2205/2011-06-16/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 44,934 mm³, 4.4% below the reference mean. With a Z-score of -0.13 (44.9th percentile), this represents normal volume ; hippocampal volume measures 5,503 mm³, 21.0% below the reference mean. With a Z-score of -1.82 (3.5th percentile), this represents moderate atrophy; whole brain volume measures 1,163,280 mm³, 13.0% above the reference mean. With a Z-score of 1.71 (95.6th percentile), this represents moderate enlargement; entorhinal cortex volume measures 2,415 mm³, 39.2% below the reference mean. With a Z-score of -2.56 (0.5th percentile), this represents significant atrophy; fusiform gyrus volume measures 19,676 mm³, 8.9% above the reference mean. With a Z-score of 0.77 (78.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,873 mm³, 8.4% above the reference mean. With a Z-score of 0.76 (77.5th percentile), this represents normal volume . ",
  "text_data": "Age is 85.2 years. Gender is Male. Education: 12 years. MMSE: 26.0. MoCA: 19.0. Laboratory findings: Vitamin B12: 1178.00 (profound elevated); Hematocrit: 50.00 (significant elevated); Hemoglobin: 17.20 (significant elevated). APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal and entorhinal cortex volumes show significant atrophy (Z-scores of -1.82 and -2.56, respectively), which are key biomarkers for Alzheimer's disease. The MMSE score of 26 is borderline, but the MoCA score of 19 suggests cognitive impairment. The absence of APOE4 does not rule out AD, especially given the structural atrophy.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given hippocampal/entorhinal atrophy)  \n\n**Confidence:** **Medium** (clinical correlation needed to confirm progression to dementia, but biomarker evidence strongly suggests MCI with high AD likelihood)",
  "timestamp": "2025-07-26T11:03:43.403884"
}