{
  "ptid_time": "014_S_0658_2012-09-18",
  "img_path": "/data/qiuhui/data/adni/images/014_S_0658/2012-09-18/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 53,106 mm³, 37.9% above the reference mean. With a Z-score of 0.91 (81.8th percentile), this represents normal volume ; hippocampal volume measures 5,403 mm³, 28.5% below the reference mean. With a Z-score of -2.78 (0.3th percentile), this represents significant atrophy; whole brain volume measures 955,383 mm³, 11.5% below the reference mean. With a Z-score of -1.49 (6.8th percentile), this represents mild atrophy; entorhinal cortex volume measures 4,075 mm³, 0.6% below the reference mean. With a Z-score of -0.04 (48.3th percentile), this represents normal volume ; fusiform gyrus volume measures 19,135 mm³, 1.6% above the reference mean. With a Z-score of 0.13 (55.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,918 mm³, 20.7% below the reference mean. With a Z-score of -1.86 (3.1th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 78.1 years. Gender is Male. Education: 18 years. MMSE: 25.0. MoCA: 24.0. Logical Memory: 3.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows significant atrophy (Z-score -2.78, 0.3rd percentile), and the middle temporal gyrus has moderate atrophy (Z-score -1.86, 3.1st percentile), both of which are strongly associated with Alzheimer's disease. The MMSE (25) and MoCA (24) scores are borderline, suggesting mild cognitive impairment rather than severe dementia.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer's pathology given hippocampal and temporal atrophy)  \n\n**Confidence:** **Medium** (due to borderline cognitive scores and lack of APOE4, but strong structural atrophy supports MCI with Alzheimer's features)",
  "timestamp": "2025-07-25T23:47:17.728464"
}