{
  "ptid_time": "016_S_4584_2013-04-13",
  "img_path": "/data/qiuhui/data/adni/images/016_S_4584/2013-04-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 34,674 mm³, 23.5% above the reference mean. With a Z-score of 0.54 (70.5th percentile), this represents normal volume ; hippocampal volume measures 5,720 mm³, 19.6% below the reference mean. With a Z-score of -1.80 (3.6th percentile), this represents moderate atrophy; whole brain volume measures 885,844 mm³, 9.1% below the reference mean. With a Z-score of -1.15 (12.6th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,258 mm³, 11.3% below the reference mean. With a Z-score of -0.69 (24.4th percentile), this represents normal volume ; fusiform gyrus volume measures 14,374 mm³, 15.5% below the reference mean. With a Z-score of -1.41 (7.9th percentile), this represents mild atrophy; middle temporal gyrus volume measures 17,064 mm³, 11.0% below the reference mean. With a Z-score of -0.95 (17.0th percentile), this represents normal volume . ",
  "text_data": "Age is 79.3 years. Gender is Female. Education: 16 years. MMSE: 26.0. MoCA: 22.0. Logical Memory: 3.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows moderate atrophy (Z-score -1.80, 3.6th percentile), which is a strong biomarker for Alzheimer's pathology. Whole brain and fusiform gyrus volumes also show mild atrophy, while other regions are within normal limits. The MMSE (26) and MoCA (22) scores suggest mild cognitive impairment, and the presence of one APOE4 allele increases Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **High**",
  "timestamp": "2025-07-26T00:27:03.906919"
}