{
  "ptid_time": "009_S_4903_2013-02-15",
  "img_path": "/data/qiuhui/data/adni/images/009_S_4903/2013-02-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 39,074 mm³, 39.2% above the reference mean. With a Z-score of 0.90 (81.5th percentile), this represents normal volume ; hippocampal volume measures 3,608 mm³, 49.3% below the reference mean. With a Z-score of -4.52 (0.0th percentile), this represents profound atrophy; whole brain volume measures 780,840 mm³, 19.9% below the reference mean. With a Z-score of -2.50 (0.6th percentile), this represents significant atrophy; entorhinal cortex volume measures 1,184 mm³, 67.8% below the reference mean. With a Z-score of -4.16 (0.0th percentile), this represents profound atrophy; fusiform gyrus volume measures 13,469 mm³, 20.8% below the reference mean. With a Z-score of -1.90 (2.9th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 13,528 mm³, 29.4% below the reference mean. With a Z-score of -2.55 (0.5th percentile), this represents significant atrophy. ",
  "text_data": "Age is 77.7 years. Gender is Female. Education: 12 years. MMSE: 27.0. MoCA: 22.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows profound atrophy in the hippocampus and entorhinal cortex, along with significant whole-brain and middle temporal gyrus atrophy—key regions affected in Alzheimer’s disease (AD). Despite relatively preserved MMSE (27/30), the MoCA (22/30) suggests mild cognitive deficits, and the presence of an APOE4 allele increases AD risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI) due to Alzheimer’s disease**  \n*(Early-stage AD is likely given the biomarker profile, but functional independence aligns with MCI.)*  \n\n**Confidence:** **High**  \n*(Convergence of structural atrophy patterns, APOE4, and subtle cognitive decline strongly supports MCI-AD.)*",
  "timestamp": "2025-07-25T22:24:25.665630"
}