{
  "ptid_time": "052_S_4626_2015-04-15",
  "img_path": "/data/qiuhui/data/adni/images/052_S_4626/2015-04-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 46,358 mm³, 20.4% above the reference mean. With a Z-score of 0.49 (68.7th percentile), this represents normal volume ; hippocampal volume measures 5,169 mm³, 31.6% below the reference mean. With a Z-score of -3.08 (0.1th percentile), this represents profound atrophy; whole brain volume measures 951,783 mm³, 11.8% below the reference mean. With a Z-score of -1.53 (6.2th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 72.2 years. Gender is Male. Education: 18 years. MMSE: 30.0. MoCA: 22.0. Logical Memory: 8.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows profound atrophy (Z-score -3.08, 0.1th percentile), which is strongly associated with Alzheimer's pathology, while whole brain volume shows moderate atrophy. Despite normal MMSE (30.0), the MoCA (22.0) suggests mild cognitive impairment, and the absence of APOE4 does not rule out neurodegeneration.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely amnestic subtype due to hippocampal atrophy).  \n\n**Confidence:** **Medium** (high confidence in hippocampal atrophy, but MoCA alone is not definitive; clinical correlation with neuropsychological testing would strengthen the diagnosis).",
  "timestamp": "2025-07-26T07:49:51.240505"
}