{
  "ptid_time": "007_S_4272_2020-01-31",
  "img_path": "/data/qiuhui/data/adni/images/007_S_4272/2020-01-31/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 44,365 mm³, 15.2% above the reference mean. With a Z-score of 0.36 (64.2th percentile), this represents normal volume ; whole brain volume measures 902,530 mm³, 16.4% below the reference mean. With a Z-score of -2.13 (1.7th percentile), this represents significant atrophy. ",
  "text_data": "Age is 78.9 years. Gender is Male. Education: 12 years. MMSE: 26.0. MoCA: 18.0. Logical Memory: 11.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant whole brain atrophy (Z-score -2.13, 1.7th percentile) with preserved ventricular volume, suggesting neurodegeneration. Cognitive testing reveals a notable discrepancy between MMSE (26, borderline normal) and MoCA (18, impaired), consistent with cognitive decline.  \n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely amnestic subtype given MoCA score).  \n**Confidence:** **Medium** (lack of detailed neuropsychological data and APOE4-negative status slightly reduce certainty).  \n\n*Note: Progression to dementia (likely Alzheimer’s) is probable given the atrophy severity, but current MoCA does not meet dementia thresholds (typically <18 for AD dementia). Follow-up with CSF biomarkers or amyloid PET could clarify.*",
  "timestamp": "2025-07-25T21:59:17.722572"
}