{
  "ptid_time": "114_S_0378_2009-04-27",
  "img_path": "/data/qiuhui/data/adni/images/114_S_0378/2009-04-27/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 45,091 mm³, 60.6% above the reference mean. With a Z-score of 1.39 (91.8th percentile), this represents mild enlargement; hippocampal volume measures 5,152 mm³, 27.6% below the reference mean. With a Z-score of -2.53 (0.6th percentile), this represents significant atrophy; whole brain volume measures 890,136 mm³, 8.7% below the reference mean. With a Z-score of -1.09 (13.7th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,169 mm³, 13.7% below the reference mean. With a Z-score of -0.84 (20.0th percentile), this represents normal volume ; fusiform gyrus volume measures 13,295 mm³, 21.9% below the reference mean. With a Z-score of -1.99 (2.3th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 15,997 mm³, 16.5% below the reference mean. With a Z-score of -1.44 (7.5th percentile), this represents mild atrophy. ",
  "text_data": "Age is 72.0 years. Gender is Female. Education: 16 years. MMSE: 27.0. Logical Memory: 1.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant hippocampal atrophy (Z-score -2.53, 0.6th percentile) and moderate fusiform gyrus atrophy (Z-score -1.99, 2.3rd percentile), both of which are strongly associated with Alzheimer's disease. The MMSE score of 27 is within the normal range, but given the structural changes, this may represent early cognitive decline. The presence of one APOE4 allele further increases Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer's disease)  \n**Confidence:** **Medium** (due to normal MMSE but significant structural atrophy)",
  "timestamp": "2025-07-26T11:40:24.244170"
}