{
  "ptid_time": "013_S_0502_2009-09-08",
  "img_path": "/data/qiuhui/data/adni/images/013_S_0502/2009-09-08/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 34,409 mm³, 10.7% below the reference mean. With a Z-score of -0.26 (39.9th percentile), this represents normal volume ; hippocampal volume measures 6,558 mm³, 13.2% below the reference mean. With a Z-score of -1.29 (9.8th percentile), this represents mild atrophy; whole brain volume measures 1,054,880 mm³, 2.3% below the reference mean. With a Z-score of -0.29 (38.4th percentile), this represents normal volume ; entorhinal cortex volume measures 3,342 mm³, 18.5% below the reference mean. With a Z-score of -1.25 (10.5th percentile), this represents mild atrophy; fusiform gyrus volume measures 16,336 mm³, 13.3% below the reference mean. With a Z-score of -1.13 (12.9th percentile), this represents mild atrophy; middle temporal gyrus volume measures 18,382 mm³, 13.9% below the reference mean. With a Z-score of -1.25 (10.6th percentile), this represents mild atrophy. ",
  "text_data": "Age is 77.9 years. Gender is Male. Education: 18 years. MMSE: 28.0. Logical Memory: 12.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal, entorhinal cortex, fusiform gyrus, and middle temporal gyrus volumes show mild atrophy (Z-scores between -1.13 and -1.29, <15th percentile), while ventricular and whole brain volumes are normal. The MMSE score of 28 is within the normal range, and there is no APOE4 risk allele. The atrophy in memory-related regions suggests early neurodegeneration, but cognitive performance remains intact.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Structural changes are present, but cognitive testing does not yet indicate dementia. Lack of APOE4 reduces but does not eliminate Alzheimer's risk.)",
  "timestamp": "2025-07-25T23:21:46.959291"
}