{
  "ptid_time": "072_S_2083_2011-09-27",
  "img_path": "/data/qiuhui/data/adni/images/072_S_2083/2011-09-27/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 50,482 mm³, 36.6% above the reference mean. With a Z-score of 0.99 (83.8th percentile), this represents normal volume ; hippocampal volume measures 4,189 mm³, 35.5% below the reference mean. With a Z-score of -2.85 (0.2th percentile), this represents significant atrophy; whole brain volume measures 873,179 mm³, 5.9% below the reference mean. With a Z-score of -0.71 (23.8th percentile), this represents normal volume ; entorhinal cortex volume measures 2,175 mm³, 37.2% below the reference mean. With a Z-score of -2.01 (2.2th percentile), this represents significant atrophy; fusiform gyrus volume measures 14,003 mm³, 13.1% below the reference mean. With a Z-score of -0.98 (16.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,171 mm³, 0.8% above the reference mean. With a Z-score of 0.07 (52.8th percentile), this represents normal volume . ",
  "text_data": "Age is 89.3 years. Gender is Female. Education: 12 years. Handedness: Right. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Endocrine-Metabolic; Renal-Genitourinary; Allergies or Drug Sensitivities; Malignancy; Major Surgical Procedures. MMSE: 26.0. MoCA: 20.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the hippocampus and entorhinal cortex, both critical regions for memory and early Alzheimer's pathology. Despite normal MMSE (26), the MoCA (20) suggests mild cognitive impairment, and the absence of APOE4 does not rule out neurodegenerative disease given the structural findings.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely amnestic subtype due to hippocampal/entorhinal atrophy).  \n\n**Confidence:** **Medium** (high confidence in neurodegeneration based on imaging, but MCI diagnosis is tempered by borderline MMSE and lack of detailed functional history).  \n\n**Note:** The hippocampal atrophy (-2.85 Z-score) and entorhinal thinning (-2.01 Z-score) are strongly suggestive of early Alzheimer’s pathology, but the preserved whole-brain volume and MMSE score justify MCI over dementia at this stage. Follow-up clinical correlation (e.g., ADL assessment, CSF biomarkers) would increase diagnostic certainty.",
  "timestamp": "2025-07-26T09:12:15.319772"
}