{
  "ptid_time": "070_S_4798_2012-06-28",
  "img_path": "/data/qiuhui/data/adni/images/070_S_4798/2012-06-28/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 59,611 mm³, 61.3% above the reference mean. With a Z-score of 1.65 (95.1th percentile), this represents moderate enlargement; whole brain volume measures 893,246 mm³, 3.8% below the reference mean. With a Z-score of -0.45 (32.6th percentile), this represents normal volume ; entorhinal cortex volume measures 2,498 mm³, 27.9% below the reference mean. With a Z-score of -1.50 (6.6th percentile), this represents moderate atrophy; fusiform gyrus volume measures 14,487 mm³, 10.1% below the reference mean. With a Z-score of -0.76 (22.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 14,750 mm³, 18.2% below the reference mean. With a Z-score of -1.62 (5.3th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 82.6 years. Gender is Female. Education: 16 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Endocrine-Metabolic; Major Surgical Procedures. MMSE: 26.0. MoCA: 22.0. Logical Memory: 3.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows moderate ventricular enlargement and significant atrophy in the entorhinal cortex and middle temporal gyrus, which are key regions affected in Alzheimer's disease. Cognitive scores (MMSE 26, MoCA 22) suggest mild cognitive impairment, and the absence of APOE4 does not rule out neurodegeneration given the structural changes.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer's pathology given the atrophy pattern).  \n\n**Confidence:** **Medium** (cognitive scores are borderline, but structural changes strongly support MCI with underlying neurodegeneration).",
  "timestamp": "2025-07-26T09:04:28.972799"
}