{
  "ptid_time": "016_S_1149_2007-03-13",
  "img_path": "/data/qiuhui/data/adni/images/016_S_1149/2007-03-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 57,158 mm³, 21.6% above the reference mean. With a Z-score of 0.63 (73.5th percentile), this represents normal volume ; hippocampal volume measures 7,713 mm³, 10.7% above the reference mean. With a Z-score of 0.92 (82.2th percentile), this represents normal volume ; whole brain volume measures 1,126,110 mm³, 9.4% above the reference mean. With a Z-score of 1.23 (89.1th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,197 mm³, 19.5% below the reference mean. With a Z-score of -1.27 (10.1th percentile), this represents mild atrophy; fusiform gyrus volume measures 17,174 mm³, 4.9% below the reference mean. With a Z-score of -0.43 (33.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 23,712 mm³, 17.6% above the reference mean. With a Z-score of 1.57 (94.2th percentile), this represents moderate enlargement. ",
  "text_data": "Age is 84.3 years. Gender is Male. Education: 20 years. MMSE: 29.0. Logical Memory: 8.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows mild atrophy (Z-score -1.27, 10.1th percentile), which is a key early marker of Alzheimer's pathology, while other regions (hippocampus, whole brain) are normal or enlarged. The MMSE score of 29 is within the normal range, and the absence of APOE4 reduces genetic risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Atrophy in the entorhinal cortex suggests early neurodegeneration, but preserved cognition and lack of APOE4 make dementia less likely at this stage.)",
  "timestamp": "2025-07-26T00:17:45.685863"
}