{
  "ptid_time": "036_S_4538_2016-06-01",
  "img_path": "/data/qiuhui/data/adni/images/036_S_4538/2016-06-01/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 46,788 mm³, 26.6% above the reference mean. With a Z-score of 0.72 (76.3th percentile), this represents normal volume ; hippocampal volume measures 5,161 mm³, 20.5% below the reference mean. With a Z-score of -1.65 (5.0th percentile), this represents moderate atrophy; whole brain volume measures 888,771 mm³, 4.2% below the reference mean. With a Z-score of -0.51 (30.5th percentile), this represents normal volume ; entorhinal cortex volume measures 2,827 mm³, 18.4% below the reference mean. With a Z-score of -0.99 (16.1th percentile), this represents normal volume ; fusiform gyrus volume measures 15,435 mm³, 4.2% below the reference mean. With a Z-score of -0.31 (37.6th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,087 mm³, 0.3% above the reference mean. With a Z-score of 0.03 (51.1th percentile), this represents normal volume . ",
  "text_data": "Age is 82.8 years. Gender is Female. Education: 15 years. MMSE: 26.0. MoCA: 17.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows moderate atrophy (Z-score -1.65, 5th percentile), which is a strong biomarker for Alzheimer's pathology. The MoCA score of 17 indicates significant cognitive impairment, while the MMSE of 26 is borderline normal, suggesting possible early dementia. The APOE4 carrier status increases Alzheimer's risk.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease)  \n**Confidence:** **High** (due to hippocampal atrophy, low MoCA, and APOE4 status)",
  "timestamp": "2025-07-26T06:15:15.899187"
}