{
  "ptid_time": "018_S_2133_2013-12-18",
  "img_path": "/data/qiuhui/data/adni/images/018_S_2133/2013-12-18/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 43,141 mm³, 93.1% above the reference mean. With a Z-score of 2.33 (99.0th percentile), this represents significant enlargement; hippocampal volume measures 6,893 mm³, 10.3% below the reference mean. With a Z-score of -1.16 (12.4th percentile), this represents mild atrophy; whole brain volume measures 1,062,850 mm³, 3.3% above the reference mean. With a Z-score of 0.41 (65.8th percentile), this represents normal volume ; entorhinal cortex volume measures 3,215 mm³, 17.4% below the reference mean. With a Z-score of -1.35 (8.9th percentile), this represents mild atrophy; fusiform gyrus volume measures 17,531 mm³, 3.7% below the reference mean. With a Z-score of -0.42 (33.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,485 mm³, 4.7% above the reference mean. With a Z-score of 0.42 (66.2th percentile), this represents normal volume . ",
  "text_data": "Age is 65.5 years. Gender is Female. Education: 18 years. MMSE: 25.0. MoCA: 22.0. Logical Memory: 7.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (93.1% above mean, Z=2.33) and mild atrophy in the hippocampus (-10.3%, Z=-1.16) and entorhinal cortex (-17.4%, Z=-1.35), which are key regions affected in Alzheimer's disease. The MMSE (25) and MoCA (22) scores indicate mild cognitive impairment, and the presence of two APOE4 alleles increases Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given biomarker and genetic profile).  \n\n**Confidence:** **High** (structural atrophy in AD-vulnerable regions, borderline cognitive scores, and strong genetic risk support this conclusion).",
  "timestamp": "2025-07-26T00:53:07.138149"
}