{
  "ptid_time": "141_S_2210_2012-02-24",
  "img_path": "/data/qiuhui/data/adni/images/141_S_2210/2012-02-24/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 72,317 mm³, 95.6% above the reference mean. With a Z-score of 2.58 (99.5th percentile), this represents significant enlargement; hippocampal volume measures 5,279 mm³, 18.7% below the reference mean. With a Z-score of -1.50 (6.7th percentile), this represents moderate atrophy; whole brain volume measures 1,002,010 mm³, 8.0% above the reference mean. With a Z-score of 0.95 (83.0th percentile), this represents normal volume ; entorhinal cortex volume measures 2,660 mm³, 23.2% below the reference mean. With a Z-score of -1.25 (10.5th percentile), this represents mild atrophy; fusiform gyrus volume measures 18,535 mm³, 15.1% above the reference mean. With a Z-score of 1.13 (87.1th percentile), this represents mild enlargement; middle temporal gyrus volume measures 18,180 mm³, 0.8% above the reference mean. With a Z-score of 0.07 (53.0th percentile), this represents normal volume . ",
  "text_data": "Age is 80.8 years. Gender is Female. Education: 12 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Allergies or Drug Sensitivities; Malignancy; Major Surgical Procedures. MMSE: 26.0. MoCA: 21.0. Logical Memory: 1.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (95.6% above mean) and moderate hippocampal atrophy (18.7% below mean), both strong indicators of neurodegeneration. The MMSE (26) and MoCA (21) scores suggest mild cognitive impairment, while the absence of APOE4 reduces genetic risk but does not rule out sporadic Alzheimer's.  \n**Diagnosis:** **MCI** (likely prodromal Alzheimer's given hippocampal/entorhinal atrophy).  \n**Confidence:** **Medium** (clinical correlation needed to exclude other causes of atrophy).  \n\n*Note: Ventricular enlargement and hippocampal atrophy are hallmark Alzheimer's biomarkers, but MCI is the most fitting diagnosis at this stage given preserved global cognition (MMSE 26).*",
  "timestamp": "2025-07-26T16:59:41.631676"
}