{
  "ptid_time": "019_S_4680_2013-05-06",
  "img_path": "/data/qiuhui/data/adni/images/019_S_4680/2013-05-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 19,987 mm³, 10.5% below the reference mean. With a Z-score of -0.26 (39.6th percentile), this represents normal volume ; hippocampal volume measures 6,183 mm³, 19.5% below the reference mean. With a Z-score of -2.19 (1.4th percentile), this represents significant atrophy; whole brain volume measures 867,382 mm³, 15.7% below the reference mean. With a Z-score of -1.96 (2.5th percentile), this represents moderate atrophy; entorhinal cortex volume measures 3,765 mm³, 3.3% below the reference mean. With a Z-score of -0.25 (39.9th percentile), this represents normal volume ; fusiform gyrus volume measures 13,739 mm³, 24.6% below the reference mean. With a Z-score of -2.76 (0.3th percentile), this represents significant atrophy; middle temporal gyrus volume measures 15,704 mm³, 23.5% below the reference mean. With a Z-score of -2.09 (1.9th percentile), this represents significant atrophy. ",
  "text_data": "Age is 64.4 years. Gender is Female. Education: 19 years. MMSE: 27.0. MoCA: 20.0. Logical Memory: 3.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in the hippocampus, fusiform gyrus, and middle temporal gyrus, which are key regions affected in Alzheimer's disease. The MoCA score of 20 (below the typical cutoff of 26) suggests cognitive impairment, while the MMSE of 27 is borderline normal, indicating possible early-stage decline. The presence of two APOE4 alleles further increases Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer's disease given the biomarker and genetic profile).  \n\n**Confidence:** **High** (due to clear structural atrophy in AD-vulnerable regions, low MoCA, and APOE4 homozygosity).",
  "timestamp": "2025-07-26T01:08:00.384645"
}