{
  "ptid_time": "009_S_4324_2012-05-14",
  "img_path": "/data/qiuhui/data/adni/images/009_S_4324/2012-05-14/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 50,831 mm³, 127.6% above the reference mean. With a Z-score of 3.19 (99.9th percentile), this represents profound enlargement; hippocampal volume measures 5,643 mm³, 26.6% below the reference mean. With a Z-score of -2.98 (0.1th percentile), this represents significant atrophy; whole brain volume measures 854,249 mm³, 17.0% below the reference mean. With a Z-score of -2.12 (1.7th percentile), this represents significant atrophy; entorhinal cortex volume measures 3,204 mm³, 17.7% below the reference mean. With a Z-score of -1.37 (8.5th percentile), this represents mild atrophy; fusiform gyrus volume measures 14,287 mm³, 21.5% below the reference mean. With a Z-score of -2.43 (0.8th percentile), this represents significant atrophy; middle temporal gyrus volume measures 16,950 mm³, 17.4% below the reference mean. With a Z-score of -1.55 (6.1th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 63.3 years. Gender is Female. Education: 14 years. MMSE: 27.0. MoCA: 21.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows profound ventricular enlargement and significant atrophy in the hippocampus, whole brain, fusiform gyrus, and middle temporal gyrus—key regions affected in Alzheimer’s disease. The MoCA score of 21 (below the typical cutoff of 26) suggests cognitive impairment, while the MMSE of 27 is borderline, possibly reflecting early-stage disease. The presence of one APOE4 allele further increases Alzheimer’s risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer’s pathology)  \n**Confidence:** **High**  \n\n*(Note: While the structural changes are severe enough to suggest dementia, the MMSE score is not yet in the dementia range. MCI is the most fitting diagnosis, but progression to dementia is highly probable.)*",
  "timestamp": "2025-07-25T22:18:05.423632"
}