{
  "ptid_time": "021_S_0626_2012-08-01",
  "img_path": "/data/qiuhui/data/adni/images/021_S_0626/2012-08-01/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 39,305 mm³, 16.4% below the reference mean. With a Z-score of -0.48 (31.7th percentile), this represents normal volume ; hippocampal volume measures 5,193 mm³, 25.5% below the reference mean. With a Z-score of -2.20 (1.4th percentile), this represents significant atrophy; whole brain volume measures 901,148 mm³, 12.4% below the reference mean. With a Z-score of -1.63 (5.2th percentile), this represents moderate atrophy; entorhinal cortex volume measures 3,648 mm³, 8.1% below the reference mean. With a Z-score of -0.53 (29.8th percentile), this represents normal volume ; fusiform gyrus volume measures 15,896 mm³, 12.0% below the reference mean. With a Z-score of -1.04 (14.9th percentile), this represents mild atrophy; middle temporal gyrus volume measures 15,632 mm³, 22.5% below the reference mean. With a Z-score of -2.02 (2.2th percentile), this represents significant atrophy. ",
  "text_data": "Age is 89.2 years. Gender is Male. Education: 16 years. MMSE: 26.0. MoCA: 21.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "Reasoning: The patient shows significant hippocampal and middle temporal gyrus atrophy (Z-scores of -2.20 and -2.02, respectively), which are strongly associated with Alzheimer's pathology. The MMSE of 26 and MoCA of 21 suggest mild cognitive impairment, though the MoCA score is more indicative of cognitive decline. The absence of APOE4 does not rule out Alzheimer's, especially given the structural atrophy.  \n\nDiagnosis: MCI (likely due to Alzheimer's pathology)  \nConfidence: Medium (clinical scores are borderline, but structural atrophy strongly supports MCI with underlying neurodegeneration)",
  "timestamp": "2025-07-26T01:33:04.018526"
}