{
  "ptid_time": "098_S_2079_2011-03-09",
  "img_path": "/data/qiuhui/data/adni/images/098_S_2079/2011-03-09/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 36,694 mm³, 22.2% above the reference mean. With a Z-score of 0.53 (70.1th percentile), this represents normal volume ; hippocampal volume measures 7,016 mm³, 12.6% below the reference mean. With a Z-score of -1.26 (10.4th percentile), this represents mild atrophy; whole brain volume measures 1,188,280 mm³, 4.7% above the reference mean. With a Z-score of 0.67 (74.9th percentile), this represents normal volume ; entorhinal cortex volume measures 5,237 mm³, 22.9% above the reference mean. With a Z-score of 1.58 (94.3th percentile), this represents moderate enlargement; fusiform gyrus volume measures 20,640 mm³, 3.7% above the reference mean. With a Z-score of 0.31 (62.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 26,195 mm³, 16.9% above the reference mean. With a Z-score of 1.39 (91.8th percentile), this represents mild enlargement. ",
  "text_data": "Age is 66.0 years. Gender is Male. Education: 13 years. MMSE: 27.0. MoCA: 25.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.26, 10.4th percentile), which is concerning for early neurodegenerative changes, while other regions (ventricular, whole brain, entorhinal cortex, fusiform gyrus, middle temporal gyrus) are normal or enlarged. Cognitive scores (MMSE 27, MoCA 25) are within normal limits, and APOE4-negative status reduces Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Hippocampal atrophy suggests early pathology, but normal cognition and lack of APOE4 make progression to dementia less certain.)",
  "timestamp": "2025-07-26T10:44:31.019920"
}