{
  "ptid_time": "036_S_2380_2019-06-05",
  "img_path": "/data/qiuhui/data/adni/images/036_S_2380/2019-06-05/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 36,039 mm³, 6.4% below the reference mean. With a Z-score of -0.15 (43.9th percentile), this represents normal volume ; hippocampal volume measures 5,971 mm³, 21.0% below the reference mean. With a Z-score of -2.05 (2.0th percentile), this represents significant atrophy; whole brain volume measures 1,197,480 mm³, 10.9% above the reference mean. With a Z-score of 1.42 (92.2th percentile), this represents mild enlargement; entorhinal cortex volume measures 2,861 mm³, 30.2% below the reference mean. With a Z-score of -2.05 (2.0th percentile), this represents significant atrophy; fusiform gyrus volume measures 22,006 mm³, 16.8% above the reference mean. With a Z-score of 1.43 (92.4th percentile), this represents mild enlargement; middle temporal gyrus volume measures 18,632 mm³, 12.7% below the reference mean. With a Z-score of -1.14 (12.7th percentile), this represents mild atrophy. ",
  "text_data": "Age is 75.8 years. Gender is Male. Education: 16 years. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in the hippocampus and entorhinal cortex (both at the 2nd percentile), which are key regions affected in Alzheimer's disease. The presence of two APOE4 alleles further increases Alzheimer's risk. However, whole brain and fusiform gyrus volumes are enlarged, which is atypical for typical AD progression.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer's given hippocampal/entorhinal atrophy and APOE4 status, but preserved global brain volume complicates a dementia diagnosis).  \n\n**Confidence:** **Medium** (strong AD biomarkers but conflicting volumetric findings).",
  "timestamp": "2025-07-26T06:12:25.693260"
}