{
  "ptid_time": "131_S_0123_2014-02-12",
  "img_path": "/data/qiuhui/data/adni/images/131_S_0123/2014-02-12/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 44,879 mm³, 4.5% below the reference mean. With a Z-score of -0.13 (44.7th percentile), this represents normal volume ; hippocampal volume measures 5,009 mm³, 28.1% below the reference mean. With a Z-score of -2.43 (0.8th percentile), this represents significant atrophy; whole brain volume measures 916,308 mm³, 11.0% below the reference mean. With a Z-score of -1.44 (7.5th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,307 mm³, 41.9% below the reference mean. With a Z-score of -2.74 (0.3th percentile), this represents significant atrophy; fusiform gyrus volume measures 16,144 mm³, 10.6% below the reference mean. With a Z-score of -0.92 (17.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 14,706 mm³, 27.1% below the reference mean. With a Z-score of -2.43 (0.8th percentile), this represents significant atrophy. ",
  "text_data": "Age is 81.3 years. Gender is Male. Education: 20 years. MMSE: 26.0. MoCA: 24.0. Logical Memory: 13.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the hippocampus, entorhinal cortex, and middle temporal gyrus—key regions affected in Alzheimer's disease. Despite relatively preserved cognitive scores (MMSE 26, MoCA 24), the structural changes suggest neurodegeneration. The absence of APOE4 reduces genetic risk but does not rule out AD.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (given preserved daily function but clear structural decline).  \n**Confidence:** **Medium** (cognitive scores are borderline, and clinical correlation is needed to confirm functional impact).  \n\n*Alternative consideration:* Early-stage dementia cannot be excluded if subtle functional deficits are present.",
  "timestamp": "2025-07-26T15:00:03.994130"
}