{
  "ptid_time": "128_S_0230_2006-03-08",
  "img_path": "/data/qiuhui/data/adni/images/128_S_0230/2006-03-08/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 39,562 mm³, 15.9% below the reference mean. With a Z-score of -0.46 (32.3th percentile), this represents normal volume ; hippocampal volume measures 5,700 mm³, 18.2% below the reference mean. With a Z-score of -1.57 (5.8th percentile), this represents moderate atrophy; whole brain volume measures 1,051,050 mm³, 2.1% above the reference mean. With a Z-score of 0.28 (61.0th percentile), this represents normal volume ; entorhinal cortex volume measures 2,366 mm³, 40.4% below the reference mean. With a Z-score of -2.64 (0.4th percentile), this represents significant atrophy; fusiform gyrus volume measures 16,394 mm³, 9.3% below the reference mean. With a Z-score of -0.80 (21.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,334 mm³, 10.7% above the reference mean. With a Z-score of 0.96 (83.2th percentile), this represents normal volume . ",
  "text_data": "Age is 80.0 years. Gender is Male. Education: 20 years. Handedness: Right. Race: White. Medical history: Musculoskeletal; Endocrine-Metabolic; Renal-Genitourinary; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 29.0. Logical Memory: 10.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in the entorhinal cortex (Z-score -2.64, 0.4th percentile) and moderate hippocampal atrophy (Z-score -1.57, 5.8th percentile), both key regions in Alzheimer's pathology. However, cognitive performance (MMSE 29/30) remains intact, and other brain regions are largely normal.  \n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (due to structural changes without overt cognitive decline).  \n**Confidence:** **Medium** (high biomarker evidence but preserved cognition complicates full dementia diagnosis).  \n\n*Note: APOE4-negative status and high MMSE suggest slower progression risk, but entorhinal/hippocampal atrophy warrants monitoring for conversion to dementia.*",
  "timestamp": "2025-07-26T13:41:18.339587"
}