{
  "ptid_time": "012_S_4188_2012-05-02",
  "img_path": "/data/qiuhui/data/adni/images/012_S_4188/2012-05-02/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 50,083 mm³, 30.0% above the reference mean. With a Z-score of 0.72 (76.4th percentile), this represents normal volume ; hippocampal volume measures 6,712 mm³, 11.2% below the reference mean. With a Z-score of -1.09 (13.7th percentile), this represents mild atrophy; whole brain volume measures 1,117,260 mm³, 3.5% above the reference mean. With a Z-score of 0.46 (67.6th percentile), this represents normal volume ; entorhinal cortex volume measures 3,415 mm³, 16.7% below the reference mean. With a Z-score of -1.13 (12.8th percentile), this represents mild atrophy; fusiform gyrus volume measures 17,983 mm³, 4.5% below the reference mean. With a Z-score of -0.39 (34.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,687 mm³, 1.6% above the reference mean. With a Z-score of 0.15 (55.8th percentile), this represents normal volume . ",
  "text_data": "Age is 77.7 years. Gender is Male. Education: 14 years. MMSE: 26.0. MoCA: 17.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal and entorhinal cortex volumes show mild atrophy (Z-scores -1.09 and -1.13, respectively), which are key regions affected in Alzheimer's disease. The MMSE score of 26 is borderline normal, but the MoCA score of 17 indicates significant cognitive impairment, consistent with MCI or early dementia. The presence of one APOE4 allele further increases Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely progressing toward Alzheimer's dementia)  \n**Confidence:** **Medium** (imaging and cognitive scores suggest MCI, but clinical correlation and longitudinal follow-up would strengthen certainty).",
  "timestamp": "2025-07-25T23:13:30.853662"
}