{
  "ptid_time": "036_S_0656_2006-07-07",
  "img_path": "/data/qiuhui/data/adni/images/036_S_0656/2006-07-07/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 27,495 mm³, 41.5% below the reference mean. With a Z-score of -1.21 (11.4th percentile), this represents mild atrophy; hippocampal volume measures 6,517 mm³, 6.5% below the reference mean. With a Z-score of -0.56 (28.8th percentile), this represents normal volume ; whole brain volume measures 989,354 mm³, 3.9% below the reference mean. With a Z-score of -0.51 (30.6th percentile), this represents normal volume ; entorhinal cortex volume measures 3,090 mm³, 22.1% below the reference mean. With a Z-score of -1.45 (7.4th percentile), this represents mild atrophy; fusiform gyrus volume measures 17,053 mm³, 5.6% below the reference mean. With a Z-score of -0.49 (31.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,717 mm³, 12.6% above the reference mean. With a Z-score of 1.13 (87.1th percentile), this represents mild enlargement. ",
  "text_data": "Age is 82.5 years. Gender is Male. Education: 13 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Endocrine-Metabolic; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking; Malignancy; Major Surgical Procedures. MMSE: 25.0. Logical Memory: 4.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows mild atrophy in the ventricular volume and entorhinal cortex, which are regions often affected in early Alzheimer's disease, while hippocampal volume is normal. The MMSE score of 25 is borderline, suggesting possible cognitive impairment, but not severe enough for dementia. The presence of one APOE4 allele increases Alzheimer's risk but does not confirm it.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to mixed findings—some atrophy but normal hippocampal volume and borderline MMSE)",
  "timestamp": "2025-07-26T06:02:01.271661"
}