{
  "ptid_time": "016_S_0590_2006-06-06",
  "img_path": "/data/qiuhui/data/adni/images/016_S_0590/2006-06-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 19,452 mm³, 30.7% below the reference mean. With a Z-score of -0.70 (24.1th percentile), this represents normal volume ; hippocampal volume measures 5,482 mm³, 22.9% below the reference mean. With a Z-score of -2.10 (1.8th percentile), this represents significant atrophy; whole brain volume measures 900,856 mm³, 7.6% below the reference mean. With a Z-score of -0.95 (17.0th percentile), this represents normal volume ; entorhinal cortex volume measures 2,493 mm³, 32.1% below the reference mean. With a Z-score of -1.97 (2.4th percentile), this represents moderate atrophy; fusiform gyrus volume measures 18,090 mm³, 6.3% above the reference mean. With a Z-score of 0.58 (71.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 14,703 mm³, 23.3% below the reference mean. With a Z-score of -2.02 (2.2th percentile), this represents significant atrophy. ",
  "text_data": "Age is 78.1 years. Gender is Female. Education: 18 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Respiratory; Musculoskeletal; Alcohol Abuse; Smoking; Major Surgical Procedures. MMSE: 27.0. Logical Memory: 2.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 609.90 pg/mL (mild reduced). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume (Z-score -2.10, 1.8th percentile) and middle temporal gyrus volume (Z-score -2.02, 2.2nd percentile) show significant atrophy, while the entorhinal cortex (Z-score -1.97, 2.4th percentile) demonstrates moderate atrophy—all key regions affected in Alzheimer’s disease. Despite a normal MMSE (27/30), the structural changes and mild Aβ reduction suggest early neurodegeneration.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer’s pathology)  \n**Confidence:** **Medium** (clinical correlation needed; MMSE is borderline, but imaging/biomarkers support MCI)",
  "timestamp": "2025-07-26T00:03:27.604091"
}