{
  "ptid_time": "137_S_4536_2012-09-10",
  "img_path": "/data/qiuhui/data/adni/images/137_S_4536/2012-09-10/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 35,451 mm³, 26.3% above the reference mean. With a Z-score of 0.60 (72.7th percentile), this represents normal volume ; hippocampal volume measures 5,967 mm³, 16.1% below the reference mean. With a Z-score of -1.48 (7.0th percentile), this represents mild atrophy; whole brain volume measures 990,579 mm³, 1.6% above the reference mean. With a Z-score of 0.21 (58.1th percentile), this represents normal volume . ",
  "text_data": "Age is 78.4 years. Gender is Female. Education: 17 years. MMSE: 28.0. MoCA: 22.0. 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 concerning for early neurodegeneration, while ventricular and whole brain volumes are normal. The MMSE is normal (28/30), but the MoCA (22/30) suggests mild cognitive impairment, particularly in executive function or attention. The absence of APOE4 reduces genetic risk but does not rule out Alzheimer's pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Hippocampal atrophy and MoCA support MCI, but MMSE is normal, and APOE4-negative status lowers certainty for Alzheimer's etiology.)",
  "timestamp": "2025-07-26T16:35:21.405690"
}