{
  "ptid_time": "024_S_0985_2011-11-17",
  "img_path": "/data/qiuhui/data/adni/images/024_S_0985/2011-11-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 52,216 mm³, 11.1% above the reference mean. With a Z-score of 0.32 (62.6th percentile), this represents normal volume ; hippocampal volume measures 5,430 mm³, 22.1% below the reference mean. With a Z-score of -1.91 (2.8th percentile), this represents moderate atrophy; whole brain volume measures 774,133 mm³, 24.8% below the reference mean. With a Z-score of -3.25 (0.1th percentile), this represents profound atrophy; entorhinal cortex volume measures 3,022 mm³, 23.9% below the reference mean. With a Z-score of -1.56 (5.9th percentile), this represents moderate atrophy; fusiform gyrus volume measures 14,320 mm³, 20.7% below the reference mean. With a Z-score of -1.80 (3.6th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 13,383 mm³, 33.7% below the reference mean. With a Z-score of -3.02 (0.1th percentile), this represents profound atrophy. ",
  "text_data": "Age is 86.6 years. Gender is Male. Education: 14 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Dermatologic-Connective Tissue; Musculoskeletal; Gastrointestinal; Hematopoietic-Lymphatic; Renal-Genitourinary; Malignancy; Major Surgical Procedures. MMSE: 26.0. MoCA: 24.0. Logical Memory: 3.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in multiple brain regions, particularly the hippocampus, entorhinal cortex, fusiform gyrus, and middle temporal gyrus, with profound whole-brain volume loss. Despite this, cognitive scores (MMSE 26, MoCA 24) are only mildly impaired, suggesting possible early-stage dementia or MCI with preserved cognitive reserve.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given APOE4 positivity and atrophy pattern).  \n\n**Confidence:** **Medium** (cognitive scores are borderline, but structural changes strongly suggest neurodegeneration).",
  "timestamp": "2025-07-26T03:12:26.939717"
}