{
  "ptid_time": "035_S_4784_2013-01-23",
  "img_path": "/data/qiuhui/data/adni/images/035_S_4784/2013-01-23/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 53,445 mm³, 44.6% above the reference mean. With a Z-score of 1.20 (88.6th percentile), this represents mild enlargement; hippocampal volume measures 3,753 mm³, 42.2% below the reference mean. With a Z-score of -3.38 (0.0th percentile), this represents profound atrophy; whole brain volume measures 1,050,120 mm³, 13.1% above the reference mean. With a Z-score of 1.58 (94.3th percentile), this represents moderate enlargement. ",
  "text_data": "Age is 82.1 years. Gender is Female. Education: 16 years. MMSE: 27.0. MoCA: 21.0. Laboratory findings: Monocytes: 0.63 (significant elevated); Neutrophils: 6.27 (significant elevated); Total Protein: 6.10 (significant reduced). APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound hippocampal atrophy (Z-score -3.38, 0th percentile), which is strongly associated with Alzheimer's pathology, alongside mild ventricular enlargement. Despite a normal MMSE (27/30), the MoCA (21/30) suggests mild cognitive impairment, likely due to the hippocampal damage. The absence of APOE4 does not rule out Alzheimer's, as hippocampal atrophy is a key biomarker.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to underlying Alzheimer's pathology)  \n\n**Confidence:** **High** (due to severe hippocampal atrophy and MoCA score below the typical MCI cutoff of 26)",
  "timestamp": "2025-07-26T05:58:43.790183"
}