{
  "ptid_time": "128_S_2130_2012-01-18",
  "img_path": "/data/qiuhui/data/adni/images/128_S_2130/2012-01-18/t1.nii.gz",
  "img_finding": "Image findings: hippocampal volume measures 5,774 mm³, 23.6% below the reference mean. With a Z-score of -2.30 (1.1th percentile), this represents significant atrophy; whole brain volume measures 1,174,050 mm³, 8.8% above the reference mean. With a Z-score of 1.14 (87.2th percentile), this represents mild enlargement; entorhinal cortex volume measures 4,240 mm³, 3.4% above the reference mean. With a Z-score of 0.23 (59.1th percentile), this represents normal volume ; fusiform gyrus volume measures 21,226 mm³, 12.7% above the reference mean. With a Z-score of 1.08 (86.0th percentile), this represents mild enlargement; middle temporal gyrus volume measures 22,016 mm³, 3.2% above the reference mean. With a Z-score of 0.29 (61.2th percentile), this represents normal volume . ",
  "text_data": "Age is 77.4 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Cardiovascular; Respiratory; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 28.0. MoCA: 25.0. Logical Memory: 9.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient exhibits significant hippocampal atrophy (Z-score -2.30, 1.1th percentile), which is strongly associated with Alzheimer's pathology, while other brain regions are normal or mildly enlarged. Despite high cognitive scores (MMSE 28, MoCA 25), hippocampal atrophy in this age group raises concern for early neurodegeneration. The absence of APOE4 reduces but does not eliminate Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely amnestic subtype given hippocampal atrophy).  \n**Confidence:** **Medium** (cognitive scores are borderline normal, but hippocampal atrophy is highly suggestive of early decline).  \n\n*Note: Follow-up clinical correlation (e.g., neuropsychological testing for memory deficits) and biomarker testing (e.g., CSF Aβ/tau or amyloid PET) would strengthen confidence.*",
  "timestamp": "2025-07-26T13:59:42.870768"
}