{
  "ptid_time": "067_S_0284_2006-03-17",
  "img_path": "/data/qiuhui/data/adni/images/067_S_0284/2006-03-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 45,737 mm³, 63.0% above the reference mean. With a Z-score of 1.44 (92.5th percentile), this represents mild enlargement; hippocampal volume measures 5,911 mm³, 16.9% below the reference mean. With a Z-score of -1.55 (6.0th percentile), this represents moderate atrophy; whole brain volume measures 919,028 mm³, 5.7% below the reference mean. With a Z-score of -0.72 (23.6th percentile), this represents normal volume ; entorhinal cortex volume measures 2,567 mm³, 30.1% below the reference mean. With a Z-score of -1.85 (3.2th percentile), this represents moderate atrophy; fusiform gyrus volume measures 15,573 mm³, 8.5% below the reference mean. With a Z-score of -0.77 (22.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 15,605 mm³, 18.6% below the reference mean. With a Z-score of -1.61 (5.3th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 76.8 years. Gender is Female. Education: 10 years. MMSE: 27.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows moderate atrophy in the hippocampus, entorhinal cortex, and middle temporal gyrus—key regions affected in Alzheimer's disease. The MMSE score of 27 is within the normal range, but structural changes suggest early neurodegeneration.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely amnestic subtype given hippocampal/entorhinal atrophy).  \n\n**Confidence:** **Medium** (imaging strongly suggests neurodegeneration, but cognitive performance is still intact; APOE4 carrier status increases likelihood of progression to dementia).  \n\n*Note: Follow-up cognitive testing (e.g., MoCA, episodic memory assessments) and CSF/pet biomarkers would help clarify if this is early Alzheimer's pathology.*",
  "timestamp": "2025-07-26T08:28:26.952370"
}