{
  "ptid_time": "073_S_0909_2006-10-02",
  "img_path": "/data/qiuhui/data/adni/images/073_S_0909/2006-10-02/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 16,488 mm³, 26.2% below the reference mean. With a Z-score of -0.66 (25.6th percentile), this represents normal volume ; hippocampal volume measures 5,408 mm³, 29.6% below the reference mean. With a Z-score of -3.32 (0.0th percentile), this represents profound atrophy; whole brain volume measures 956,551 mm³, 7.1% below the reference mean. With a Z-score of -0.88 (19.0th percentile), this represents normal volume ; entorhinal cortex volume measures 2,903 mm³, 25.4% below the reference mean. With a Z-score of -1.97 (2.4th percentile), this represents moderate atrophy; fusiform gyrus volume measures 17,735 mm³, 2.6% below the reference mean. With a Z-score of -0.29 (38.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,197 mm³, 16.2% below the reference mean. With a Z-score of -1.44 (7.5th percentile), this represents mild atrophy. ",
  "text_data": "Age is 69.1 years. Gender is Female. Education: 18 years. MMSE: 27.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows profound atrophy (Z-score -3.32, 0th percentile), and the entorhinal cortex has moderate atrophy (Z-score -1.97, 2.4th percentile), both strongly associated with Alzheimer's pathology. Despite a normal MMSE (27/30), these structural changes suggest neurodegeneration. The presence of one APOE4 allele further increases Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer's pathology)  \n**Confidence:** **High** (due to significant hippocampal/entorhinal atrophy despite normal MMSE)",
  "timestamp": "2025-07-26T09:35:13.794307"
}