{
  "ptid_time": "129_S_0778_2011-09-12",
  "img_path": "/data/qiuhui/data/adni/images/129_S_0778/2011-09-12/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 33,744 mm³, 12.4% below the reference mean. With a Z-score of -0.30 (38.3th percentile), this represents normal volume ; hippocampal volume measures 6,671 mm³, 11.7% below the reference mean. With a Z-score of -1.15 (12.6th percentile), this represents mild atrophy; whole brain volume measures 1,023,540 mm³, 5.2% below the reference mean. With a Z-score of -0.67 (25.1th percentile), this represents normal volume ; entorhinal cortex volume measures 4,301 mm³, 4.9% above the reference mean. With a Z-score of 0.33 (63.0th percentile), this represents normal volume ; fusiform gyrus volume measures 19,194 mm³, 1.9% above the reference mean. With a Z-score of 0.16 (56.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 23,732 mm³, 11.2% above the reference mean. With a Z-score of 1.01 (84.3th percentile), this represents mild enlargement. ",
  "text_data": "Age is 77.4 years. Gender is Male. Education: 13 years. Handedness: Right. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Dermatologic-Connective Tissue; Musculoskeletal; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 26.0. MoCA: 26.0. Logical Memory: 3.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.15, 12.6th percentile), which is a key biomarker for Alzheimer’s pathology, while other brain volumes are largely within normal ranges. Cognitive scores (MMSE 26, MoCA 26) are borderline but still within normal limits for age, suggesting no significant functional impairment.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Hippocampal atrophy supports neurodegeneration, but cognitive scores are not clearly impaired, and APOE4 status increases risk but is not definitive.)",
  "timestamp": "2025-07-26T14:09:47.910974"
}