{
  "ptid_time": "041_S_4720_2013-05-17",
  "img_path": "/data/qiuhui/data/adni/images/041_S_4720/2013-05-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 34,688 mm³, 9.9% below the reference mean. With a Z-score of -0.24 (40.6th percentile), this represents normal volume ; hippocampal volume measures 6,560 mm³, 13.2% below the reference mean. With a Z-score of -1.29 (9.9th percentile), this represents mild atrophy; whole brain volume measures 1,108,180 mm³, 2.7% above the reference mean. With a Z-score of 0.35 (63.5th percentile), this represents normal volume ; entorhinal cortex volume measures 4,080 mm³, 0.5% below the reference mean. With a Z-score of -0.03 (48.6th percentile), this represents normal volume ; fusiform gyrus volume measures 22,370 mm³, 18.7% above the reference mean. With a Z-score of 1.60 (94.5th percentile), this represents moderate enlargement; middle temporal gyrus volume measures 21,485 mm³, 0.7% above the reference mean. With a Z-score of 0.06 (52.5th percentile), this represents normal volume . ",
  "text_data": "Age is 78.4 years. Gender is Male. Education: 16 years. MMSE: 25.0. MoCA: 23.0. Logical Memory: 3.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.29, 9.9th percentile), which is a key biomarker for Alzheimer's disease, while other brain regions are largely normal or even enlarged (fusiform gyrus). Cognitive scores (MMSE 25, MoCA 23) are borderline, suggesting possible mild cognitive impairment (MCI). The presence of two APOE4 alleles increases Alzheimer's risk.  \n\n**Diagnosis:** **MCI** (likely prodromal Alzheimer's given hippocampal atrophy and APOE4 status)  \n**Confidence:** **Medium** (cognitive scores are not severely impaired, but hippocampal atrophy and genetic risk support MCI with progression to dementia likely)",
  "timestamp": "2025-07-26T07:19:54.207296"
}