{
  "ptid_time": "131_S_0123_2012-03-16",
  "img_path": "/data/qiuhui/data/adni/images/131_S_0123/2012-03-16/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 40,097 mm³, 4.1% above the reference mean. With a Z-score of 0.10 (53.9th percentile), this represents normal volume ; hippocampal volume measures 5,382 mm³, 28.8% below the reference mean. With a Z-score of -2.81 (0.2th percentile), this represents significant atrophy; whole brain volume measures 925,452 mm³, 14.3% below the reference mean. With a Z-score of -1.85 (3.2th percentile), this represents moderate atrophy; entorhinal cortex volume measures 2,471 mm³, 39.7% below the reference mean. With a Z-score of -2.69 (0.4th percentile), this represents significant atrophy; fusiform gyrus volume measures 17,268 mm³, 8.3% below the reference mean. With a Z-score of -0.71 (23.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,108 mm³, 24.5% below the reference mean. With a Z-score of -2.20 (1.4th percentile), this represents significant atrophy. ",
  "text_data": "Age is 79.3 years. Gender is Male. Education: 20 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Hematopoietic-Lymphatic; Smoking; Major Surgical Procedures. MMSE: 27.0. MoCA: 23.0. Logical Memory: 17.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant atrophy in the hippocampus, entorhinal cortex, and middle temporal gyrus—key regions affected in Alzheimer's disease. The MMSE (27) is borderline normal, but the MoCA (23) suggests mild cognitive impairment, aligning with structural findings.  \n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given atrophy pattern).  \n**Confidence:** **High** (due to concordance between imaging and cognitive scores).  \n\n*Note:* APOE4-negative status slightly reduces Alzheimer’s likelihood, but the atrophy pattern is highly suggestive. Clinical correlation (e.g., CSF biomarkers/further neuropsych testing) would strengthen certainty.",
  "timestamp": "2025-07-26T14:59:48.065490"
}