{
  "ptid_time": "098_S_4059_2012-08-06",
  "img_path": "/data/qiuhui/data/adni/images/098_S_4059/2012-08-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 47,562 mm³, 23.5% above the reference mean. With a Z-score of 0.56 (71.3th percentile), this represents normal volume ; hippocampal volume measures 6,327 mm³, 16.3% below the reference mean. With a Z-score of -1.59 (5.6th percentile), this represents moderate atrophy; whole brain volume measures 1,025,990 mm³, 4.9% below the reference mean. With a Z-score of -0.64 (26.0th percentile), this represents normal volume ; entorhinal cortex volume measures 3,494 mm³, 14.8% below the reference mean. With a Z-score of -1.00 (15.8th percentile), this represents mild atrophy; fusiform gyrus volume measures 16,811 mm³, 10.8% below the reference mean. With a Z-score of -0.92 (18.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,341 mm³, 14.0% below the reference mean. With a Z-score of -1.26 (10.3th percentile), this represents mild atrophy. ",
  "text_data": "Age is 72.9 years. Gender is Male. Education: 18 years. MMSE: 25.0. MoCA: 19.0. Logical Memory: 5.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows moderate atrophy (Z-score -1.59, 5.6th percentile), and the entorhinal cortex and middle temporal gyrus exhibit mild atrophy. The MMSE (25) is borderline, while the MoCA (19) suggests cognitive impairment. The presence of two APOE4 alleles increases Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given hippocampal atrophy and APOE4 status)  \n\n**Confidence:** **Medium** (imaging supports neurodegeneration, but clinical correlation is needed to rule out other causes of cognitive decline).",
  "timestamp": "2025-07-26T10:47:28.793301"
}