{
  "ptid_time": "035_S_0292_2007-11-08",
  "img_path": "/data/qiuhui/data/adni/images/035_S_0292/2007-11-08/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 45,816 mm³, 18.9% above the reference mean. With a Z-score of 0.45 (67.5th percentile), this represents normal volume ; hippocampal volume measures 5,406 mm³, 28.5% below the reference mean. With a Z-score of -2.78 (0.3th percentile), this represents significant atrophy; whole brain volume measures 1,052,880 mm³, 2.5% below the reference mean. With a Z-score of -0.32 (37.5th percentile), this represents normal volume ; entorhinal cortex volume measures 2,166 mm³, 47.2% below the reference mean. With a Z-score of -3.20 (0.1th percentile), this represents profound atrophy; fusiform gyrus volume measures 17,624 mm³, 6.4% below the reference mean. With a Z-score of -0.55 (29.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,194 mm³, 14.7% below the reference mean. With a Z-score of -1.32 (9.3th percentile), this represents mild atrophy. ",
  "text_data": "Age is 77.9 years. Gender is Male. Education: 16 years. MMSE: 25.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant hippocampal atrophy (Z-score -2.78) and profound entorhinal cortex atrophy (Z-score -3.20), both strongly associated with Alzheimer's pathology. The MMSE score of 25 is borderline, but the structural changes suggest neurodegeneration beyond normal aging.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given biomarker profile)  \n**Confidence:** **High** (due to clear atrophy in AD-vulnerable regions despite borderline MMSE)",
  "timestamp": "2025-07-26T05:45:56.556853"
}