{
  "ptid_time": "137_S_4596_2012-10-08",
  "img_path": "/data/qiuhui/data/adni/images/137_S_4596/2012-10-08/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 32,849 mm³, 9.4% above the reference mean. With a Z-score of 0.22 (58.8th percentile), this represents normal volume ; hippocampal volume measures 6,150 mm³, 23.4% below the reference mean. With a Z-score of -2.34 (1.0th percentile), this represents significant atrophy; whole brain volume measures 1,065,250 mm³, 6.1% below the reference mean. With a Z-score of -0.86 (19.4th percentile), this represents normal volume . ",
  "text_data": "Age is 66.2 years. Gender is Male. Education: 20 years. MMSE: 26.0. MoCA: 20.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows significant atrophy (Z-score -2.34, 1st percentile), which is strongly associated with Alzheimer's pathology. The MMSE (26) is borderline, while the MoCA (20) suggests mild cognitive impairment. The absence of APOE4 does not rule out AD, as hippocampal atrophy is a key biomarker.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to underlying Alzheimer's pathology)  \n**Confidence:** **High** (due to clear hippocampal atrophy and cognitive test results)",
  "timestamp": "2025-07-26T16:37:29.832066"
}