{
  "ptid_time": "022_S_0543_2006-05-22",
  "img_path": "/data/qiuhui/data/adni/images/022_S_0543/2006-05-22/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 25,955 mm³, 7.5% below the reference mean. With a Z-score of -0.17 (43.2th percentile), this represents normal volume ; hippocampal volume measures 5,292 mm³, 25.6% below the reference mean. With a Z-score of -2.35 (0.9th percentile), this represents significant atrophy; whole brain volume measures 746,617 mm³, 23.4% below the reference mean. With a Z-score of -2.95 (0.2th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,717 mm³, 26.0% below the reference mean. With a Z-score of -1.60 (5.5th percentile), this represents moderate atrophy; fusiform gyrus volume measures 11,537 mm³, 32.2% below the reference mean. With a Z-score of -2.93 (0.2th percentile), this represents significant atrophy; middle temporal gyrus volume measures 12,167 mm³, 36.5% below the reference mean. With a Z-score of -3.17 (0.1th percentile), this represents profound atrophy. ",
  "text_data": "Age is 72.2 years. Gender is Female. Education: 18 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Renal-Genitourinary; Major Surgical Procedures. MMSE: 25.0. Logical Memory: 1.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in multiple brain regions critical for memory and cognition (hippocampus, whole brain, fusiform gyrus, middle temporal gyrus), with Z-scores well below the 5th percentile in most areas. The MMSE score of 25 is borderline but still within the normal range, though this may reflect early cognitive decline given the structural findings. The presence of one APOE4 allele increases Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer's given the hippocampal and temporal atrophy pattern).  \n\n**Confidence:** **Medium** (clinical correlation needed—neuropsychological testing would strengthen the diagnosis, as the MMSE alone is insensitive to early MCI).  \n\n*Note: The profound atrophy in Alzheimer’s-vulnerable regions (e.g., hippocampus, MTG) suggests high risk for progression to dementia, but MCI is the appropriate diagnosis currently given the MMSE score.*",
  "timestamp": "2025-07-26T02:05:24.856268"
}