{
  "ptid_time": "057_S_4909_2013-08-22",
  "img_path": "/data/qiuhui/data/adni/images/057_S_4909/2013-08-22/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 53,455 mm³, 90.4% above the reference mean. With a Z-score of 2.07 (98.1th percentile), this represents significant enlargement; hippocampal volume measures 5,425 mm³, 23.7% below the reference mean. With a Z-score of -2.18 (1.5th percentile), this represents significant atrophy; whole brain volume measures 891,477 mm³, 8.5% below the reference mean. With a Z-score of -1.07 (14.1th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,379 mm³, 35.2% below the reference mean. With a Z-score of -2.16 (1.5th percentile), this represents significant atrophy; fusiform gyrus volume measures 14,882 mm³, 12.5% below the reference mean. With a Z-score of -1.14 (12.7th percentile), this represents mild atrophy; middle temporal gyrus volume measures 17,193 mm³, 10.3% below the reference mean. With a Z-score of -0.90 (18.5th percentile), this represents normal volume . ",
  "text_data": "Age is 79.2 years. Gender is Female. Education: 11 years. MMSE: 26.0. MoCA: 23.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant hippocampal and entorhinal cortex atrophy, both key regions in Alzheimer's pathology, alongside ventricular enlargement (indicative of brain volume loss). Mild whole-brain and fusiform gyrus atrophy are also present. Cognitive scores (MMSE 26, MoCA 23) suggest mild impairment, consistent with early-stage cognitive decline. APOE4 positivity further supports Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer's pathology).  \n\n**Confidence:** **High** (structural and cognitive findings align strongly with MCI, and APOE4 reinforces the likelihood of neurodegenerative etiology).  \n\n*Note: Progression to dementia is likely if hippocampal/entorhinal atrophy worsens and cognitive scores decline further.*",
  "timestamp": "2025-07-26T08:14:40.975235"
}