{
  "ptid_time": "126_S_4743_2012-09-07",
  "img_path": "/data/qiuhui/data/adni/images/126_S_4743/2012-09-07/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 44,542 mm³, 15.6% above the reference mean. With a Z-score of 0.37 (64.6th percentile), this represents normal volume ; hippocampal volume measures 6,146 mm³, 18.7% below the reference mean. With a Z-score of -1.82 (3.4th percentile), this represents moderate atrophy; whole brain volume measures 1,116,090 mm³, 3.4% above the reference mean. With a Z-score of 0.44 (67.0th percentile), this represents normal volume ; entorhinal cortex volume measures 3,041 mm³, 25.8% below the reference mean. With a Z-score of -1.75 (4.0th percentile), this represents moderate atrophy; fusiform gyrus volume measures 18,570 mm³, 1.4% below the reference mean. With a Z-score of -0.12 (45.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,993 mm³, 3.1% above the reference mean. With a Z-score of 0.28 (60.9th percentile), this represents normal volume . ",
  "text_data": "Age is 70.6 years. Gender is Male. Education: 12 years. MMSE: 26.0. MoCA: 20.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows moderate atrophy in the hippocampus and entorhinal cortex, both critical regions for memory and early Alzheimer's pathology. The MMSE (26) is borderline, while the MoCA (20) suggests mild cognitive impairment, consistent with structural findings. APOE4 positivity further increases Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer's given biomarker profile)  \n**Confidence:** **High** (imaging, cognitive scores, and genetic risk align with MCI due to Alzheimer's)  \n\n*Note: Progression to dementia is likely if hippocampal/entorhinal atrophy worsens and cognitive scores decline further. CSF biomarkers or amyloid PET could strengthen the diagnosis.*",
  "timestamp": "2025-07-26T12:50:03.386381"
}