{
  "ptid_time": "099_S_4157_2012-09-25",
  "img_path": "/data/qiuhui/data/adni/images/099_S_4157/2012-09-25/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 36,833 mm³, 0.4% below the reference mean. With a Z-score of -0.01 (49.6th percentile), this represents normal volume ; hippocampal volume measures 4,725 mm³, 27.3% below the reference mean. With a Z-score of -2.18 (1.4th percentile), this represents significant atrophy; whole brain volume measures 891,872 mm³, 3.9% below the reference mean. With a Z-score of -0.47 (31.9th percentile), this represents normal volume ; entorhinal cortex volume measures 3,222 mm³, 6.9% below the reference mean. With a Z-score of -0.38 (35.4th percentile), this represents normal volume ; fusiform gyrus volume measures 16,626 mm³, 3.2% above the reference mean. With a Z-score of 0.24 (59.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,599 mm³, 7.9% below the reference mean. With a Z-score of -0.71 (24.0th percentile), this represents normal volume . ",
  "text_data": "Age is 82.1 years. Gender is Female. Education: 19 years. MMSE: 27.0. MoCA: 24.0. Logical Memory: 12.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows significant atrophy (Z-score -2.18, 1.4th percentile), which is a strong biomarker for Alzheimer's disease, while other brain regions are within normal limits. The MMSE (27) and MoCA (24) scores suggest mild cognitive impairment rather than dementia, as they are slightly below optimal but not severely impaired. The absence of APOE4 reduces genetic risk but does not rule out AD.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to underlying Alzheimer's pathology given hippocampal atrophy)  \n\n**Confidence:** **Medium** (clinical scores are borderline, but hippocampal atrophy strongly supports neurodegenerative etiology)",
  "timestamp": "2025-07-26T11:06:41.026744"
}