{
  "ptid_time": "100_S_0006_2006-06-02",
  "img_path": "/data/qiuhui/data/adni/images/100_S_0006/2006-06-02/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 40,165 mm³, 8.7% above the reference mean. With a Z-score of 0.23 (59.2th percentile), this represents normal volume ; hippocampal volume measures 5,542 mm³, 14.7% below the reference mean. With a Z-score of -1.18 (12.0th percentile), this represents mild atrophy; whole brain volume measures 957,221 mm³, 3.1% above the reference mean. With a Z-score of 0.38 (64.6th percentile), this represents normal volume ; entorhinal cortex volume measures 2,480 mm³, 28.4% below the reference mean. With a Z-score of -1.53 (6.3th percentile), this represents moderate atrophy; fusiform gyrus volume measures 18,458 mm³, 14.6% above the reference mean. With a Z-score of 1.10 (86.3th percentile), this represents mild enlargement; middle temporal gyrus volume measures 18,689 mm³, 3.7% above the reference mean. With a Z-score of 0.33 (62.8th percentile), this represents normal volume . ",
  "text_data": "Age is 80.9 years. Gender is Female. Education: 13 years. MMSE: 21.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in the hippocampus (-1.18 Z-score, 12th percentile) and entorhinal cortex (-1.53 Z-score, 6.3rd percentile), both key regions affected in Alzheimer's disease. The MMSE score of 21 suggests cognitive impairment, but the absence of APOE4 reduces genetic risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely amnestic subtype due to hippocampal/entorhinal atrophy).  \n\n**Confidence:** **Medium** (strong structural evidence but lack of APOE4 and need for further clinical correlation, such as neuropsychological testing or CSF biomarkers, to confirm progression to dementia).",
  "timestamp": "2025-07-26T11:13:35.479801"
}