{
  "ptid_time": "003_S_6432_2019-07-24",
  "img_path": "/data/qiuhui/data/adni/images/003_S_6432/2019-07-24/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 29,834 mm³, 33.6% above the reference mean. With a Z-score of 0.84 (80.0th percentile), this represents normal volume ; hippocampal volume measures 6,466 mm³, 15.9% below the reference mean. With a Z-score of -1.78 (3.8th percentile), this represents moderate atrophy; whole brain volume measures 878,176 mm³, 14.7% below the reference mean. With a Z-score of -1.83 (3.4th percentile), this represents moderate atrophy; entorhinal cortex volume measures 3,559 mm³, 8.6% below the reference mean. With a Z-score of -0.66 (25.3th percentile), this represents normal volume ; fusiform gyrus volume measures 19,156 mm³, 5.2% above the reference mean. With a Z-score of 0.58 (72.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,173 mm³, 21.2% below the reference mean. With a Z-score of -1.88 (3.0th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 68.3 years. Gender is Female. Education: 18 years. MMSE: 28.0. MoCA: 22.0. Logical Memory: 9.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows moderate atrophy in the hippocampus, whole brain, and middle temporal gyrus—key regions affected in Alzheimer’s disease. Despite a normal MMSE (28/30), the MoCA (22/30) suggests mild cognitive impairment, and the presence of two APOE4 alleles increases AD risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given biomarker profile).  \n\n**Confidence:** **High** (due to concordance between imaging atrophy patterns, borderline MoCA, and genetic risk).",
  "timestamp": "2025-07-25T21:01:49.813404"
}