{
  "ptid_time": "016_S_6790_2020-10-21",
  "img_path": "/data/qiuhui/data/adni/images/016_S_6790/2020-10-21/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 87,052 mm³, 126.0% above the reference mean. With a Z-score of 3.02 (99.9th percentile), this represents profound enlargement; hippocampal volume measures 6,845 mm³, 9.4% below the reference mean. With a Z-score of -0.92 (17.8th percentile), this represents normal volume ; whole brain volume measures 1,072,100 mm³, 0.7% below the reference mean. With a Z-score of -0.09 (46.5th percentile), this represents normal volume ; entorhinal cortex volume measures 2,648 mm³, 35.4% below the reference mean. With a Z-score of -2.40 (0.8th percentile), this represents significant atrophy; fusiform gyrus volume measures 13,558 mm³, 28.0% below the reference mean. With a Z-score of -2.39 (0.8th percentile), this represents significant atrophy; middle temporal gyrus volume measures 19,163 mm³, 10.2% below the reference mean. With a Z-score of -0.92 (18.0th percentile), this represents normal volume . ",
  "text_data": "Age is 79.4 years. Gender is Male. Education: 13 years. MMSE: 23.0. MoCA: 20.0. Logical Memory: 17.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant atrophy in the entorhinal cortex and fusiform gyrus, both critical regions for memory and cognitive function, alongside profound ventricular enlargement (indicative of brain atrophy). The hippocampal volume is within normal limits, but the cognitive scores (MMSE 23, MoCA 20) suggest mild impairment. The absence of APOE4 reduces genetic risk but does not rule out neurodegenerative disease.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely amnestic subtype given entorhinal atrophy and cognitive scores).  \n\n**Confidence:** **Medium** (due to normal hippocampal volume but clear structural and cognitive deficits).  \n\n*Note: Progression to dementia (likely Alzheimer’s) is plausible given the entorhinal/fusiform atrophy, but current cognitive deficits align more closely with MCI.*",
  "timestamp": "2025-07-26T00:40:17.460704"
}