{
  "ptid_time": "127_S_4197_2012-02-15",
  "img_path": "/data/qiuhui/data/adni/images/127_S_4197/2012-02-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 62,463 mm³, 62.2% above the reference mean. With a Z-score of 1.49 (93.2th percentile), this represents mild enlargement; hippocampal volume measures 6,329 mm³, 16.3% below the reference mean. With a Z-score of -1.59 (5.6th percentile), this represents moderate atrophy; whole brain volume measures 1,107,520 mm³, 2.6% above the reference mean. With a Z-score of 0.34 (63.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,013 mm³, 26.5% below the reference mean. With a Z-score of -1.80 (3.6th percentile), this represents moderate atrophy; fusiform gyrus volume measures 18,651 mm³, 1.0% below the reference mean. With a Z-score of -0.08 (46.6th percentile), this represents normal volume ; middle temporal gyrus volume measures 23,630 mm³, 10.7% above the reference mean. With a Z-score of 0.97 (83.3th percentile), this represents normal volume . ",
  "text_data": "Age is 79.8 years. Gender is Male. Education: 20 years. MMSE: 29.0. MoCA: 24.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging shows moderate atrophy in the hippocampus and entorhinal cortex, both key regions affected in Alzheimer's disease, while ventricular enlargement suggests mild atrophy. Despite high MMSE (29), the MoCA (24) indicates subtle cognitive impairment, and the presence of one APOE4 allele increases Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given biomarker profile)  \n**Confidence:** **Medium** (clinical scores are borderline, but structural atrophy supports MCI with neurodegenerative etiology)",
  "timestamp": "2025-07-26T13:14:06.443092"
}