{
  "ptid_time": "082_S_2121_2011-11-09",
  "img_path": "/data/qiuhui/data/adni/images/082_S_2121/2011-11-09/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 23,986 mm³, 7.4% above the reference mean. With a Z-score of 0.18 (57.3th percentile), this represents normal volume ; hippocampal volume measures 6,900 mm³, 10.2% below the reference mean. With a Z-score of -1.15 (12.6th percentile), this represents mild atrophy; whole brain volume measures 1,125,870 mm³, 9.4% above the reference mean. With a Z-score of 1.17 (87.9th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,547 mm³, 8.9% below the reference mean. With a Z-score of -0.69 (24.6th percentile), this represents normal volume ; fusiform gyrus volume measures 22,085 mm³, 21.3% above the reference mean. With a Z-score of 2.40 (99.2th percentile), this represents significant enlargement; middle temporal gyrus volume measures 22,217 mm³, 8.3% above the reference mean. With a Z-score of 0.74 (76.9th percentile), this represents normal volume . ",
  "text_data": "Age is 68.8 years. Gender is Female. Education: 14 years. Handedness: Right. Race: White. Medical history: Cardiovascular; Musculoskeletal; Endocrine-Metabolic; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 27.0. MoCA: 28.0. Logical Memory: 9.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.15, 12.6th percentile), which is a key biomarker for Alzheimer’s pathology, while other regions (ventricular, whole brain, entorhinal cortex, middle temporal gyrus) are normal or enlarged. Cognitive scores (MMSE 27, MoCA 28) are within normal limits, and APOE4 heterozygosity increases Alzheimer’s risk but does not confirm disease.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (due to hippocampal atrophy despite normal cognition, suggesting early neurodegenerative changes).  \n\n**Confidence:** **Medium** (cognitive scores are normal, but hippocampal atrophy raises concern for prodromal Alzheimer’s; clinical correlation needed).",
  "timestamp": "2025-07-26T10:03:20.142050"
}