{
  "ptid_time": "002_S_0954_2008-06-05",
  "img_path": "/data/qiuhui/data/adni/images/002_S_0954/2008-06-05/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 11,689 mm³, 58.4% below the reference mean. With a Z-score of -1.34 (9.1th percentile), this represents mild atrophy; hippocampal volume measures 5,184 mm³, 27.1% below the reference mean. With a Z-score of -2.49 (0.6th percentile), this represents significant atrophy; whole brain volume measures 809,716 mm³, 16.9% below the reference mean. With a Z-score of -2.13 (1.7th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,164 mm³, 41.1% below the reference mean. With a Z-score of -2.52 (0.6th percentile), this represents significant atrophy; fusiform gyrus volume measures 12,811 mm³, 24.7% below the reference mean. With a Z-score of -2.25 (1.2th percentile), this represents significant atrophy; middle temporal gyrus volume measures 12,977 mm³, 32.3% below the reference mean. With a Z-score of -2.80 (0.3th percentile), this represents significant atrophy. ",
  "text_data": "Age is 70.8 years. Gender is Female. Education: 14 years. MMSE: 27.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in multiple brain regions, including the hippocampus, entorhinal cortex, fusiform gyrus, and middle temporal gyrus, all with Z-scores below -2.0 (≤1.7th percentile). These regions are critical for memory and cognitive function, and their atrophy is strongly associated with Alzheimer's pathology. Despite the relatively preserved MMSE score (27/30), the structural changes suggest early neurodegeneration.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer's pathology given the APOE4 carrier status and hippocampal/entorhinal atrophy).  \n\n**Confidence:** **High** (due to the strong imaging evidence of atrophy in Alzheimer’s-vulnerable regions, even with a near-normal MM",
  "timestamp": "2025-07-25T20:08:32.651989"
}