{
  "ptid_time": "033_S_5013_2013-12-02",
  "img_path": "/data/qiuhui/data/adni/images/033_S_5013/2013-12-02/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 29,440 mm³, 31.8% above the reference mean. With a Z-score of 0.80 (78.7th percentile), this represents normal volume ; hippocampal volume measures 6,479 mm³, 15.7% below the reference mean. With a Z-score of -1.76 (3.9th percentile), this represents moderate atrophy; whole brain volume measures 1,018,290 mm³, 1.1% below the reference mean. With a Z-score of -0.13 (44.8th percentile), this represents normal volume ; entorhinal cortex volume measures 2,555 mm³, 34.4% below the reference mean. With a Z-score of -2.66 (0.4th percentile), this represents significant atrophy; fusiform gyrus volume measures 15,205 mm³, 16.5% below the reference mean. With a Z-score of -1.86 (3.2th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 20,679 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 69.3 years. Gender is Female. Education: 18 years. MMSE: 23.0. MoCA: 20.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "Reasoning: The patient shows significant atrophy in the entorhinal cortex (Z-score -2.66) and moderate atrophy in the hippocampus (Z-score -1.76) and fusiform gyrus (Z-score -1.86), which are key regions affected in Alzheimer's disease. Cognitive testing (MMSE 23, MoCA 20) indicates mild cognitive impairment, and the absence of APOE4 does not rule out AD.  \nDiagnosis: **Mild Cognitive Impairment (MCI) likely due to Alzheimer's pathology**  \nConfidence: **Medium** (due to clear structural atrophy but lack of progression data or biomarker confirmation)",
  "timestamp": "2025-07-26T05:37:39.363243"
}