{
  "ptid_time": "098_S_2079_2011-10-24",
  "img_path": "/data/qiuhui/data/adni/images/098_S_2079/2011-10-24/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 34,750 mm³, 15.7% above the reference mean. With a Z-score of 0.37 (64.6th percentile), this represents normal volume ; hippocampal volume measures 6,840 mm³, 14.8% below the reference mean. With a Z-score of -1.48 (7.0th percentile), this represents mild atrophy; whole brain volume measures 1,196,590 mm³, 5.5% above the reference mean. With a Z-score of 0.77 (78.1th percentile), this represents normal volume ; entorhinal cortex volume measures 4,751 mm³, 11.5% above the reference mean. With a Z-score of 0.79 (78.6th percentile), this represents normal volume ; fusiform gyrus volume measures 20,593 mm³, 3.4% above the reference mean. With a Z-score of 0.29 (61.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 24,978 mm³, 11.5% above the reference mean. With a Z-score of 0.94 (82.7th percentile), this represents normal volume . ",
  "text_data": "Age is 66.5 years. Gender is Male. Education: 13 years. Handedness: Left. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking; Malignancy; Major Surgical Procedures. MMSE: 22.0. MoCA: 21.0. Logical Memory: 5.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.48, 7th percentile), which is a key biomarker for Alzheimer's disease, while other brain regions are within normal ranges. The cognitive scores (MMSE 22, MoCA 21) are below expected norms for age, suggesting cognitive impairment. The absence of APOE4 reduces genetic risk but does not rule out neurodegeneration.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Cognitive decline is evident, but hippocampal atrophy alone without more severe global atrophy or stronger biomarker evidence limits certainty.)",
  "timestamp": "2025-07-26T10:44:37.568634"
}