{
  "ptid_time": "099_S_4498_2013-02-25",
  "img_path": "/data/qiuhui/data/adni/images/099_S_4498/2013-02-25/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 31,124 mm³, 10.9% above the reference mean. With a Z-score of 0.25 (59.8th percentile), this represents normal volume ; hippocampal volume measures 4,722 mm³, 33.6% below the reference mean. With a Z-score of -3.08 (0.1th percentile), this represents profound atrophy; whole brain volume measures 887,977 mm³, 8.9% below the reference mean. With a Z-score of -1.12 (13.1th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,455 mm³, 33.2% below the reference mean. With a Z-score of -2.04 (2.1th percentile), this represents significant atrophy; fusiform gyrus volume measures 13,806 mm³, 18.9% below the reference mean. With a Z-score of -1.72 (4.3th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 15,894 mm³, 17.1% below the reference mean. With a Z-score of -1.48 (6.9th percentile), this represents mild atrophy. ",
  "text_data": "Age is 78.5 years. Gender is Female. Education: 14 years. MMSE: 27.0. MoCA: 21.0. Logical Memory: 3.0. Laboratory findings: Albumin: 3.40 (significant reduced); Calcium (EDTA): 9.00 (significant reduced). APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows profound hippocampal atrophy (Z-score -3.08, 0.1th percentile) and significant entorhinal cortex atrophy (Z-score -2.04, 2.1th percentile), both strongly associated with Alzheimer's pathology. The MoCA score of 21 suggests cognitive impairment, while the MMSE of 27 is borderline normal, indicating possible early-stage decline. The absence of APOE4 does not rule out Alzheimer's, as atrophy patterns are highly suggestive.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**",
  "timestamp": "2025-07-26T11:09:56.765112"
}