{
  "ptid_time": "141_S_0851_2007-10-13",
  "img_path": "/data/qiuhui/data/adni/images/141_S_0851/2007-10-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 17,499 mm³, 37.7% below the reference mean. With a Z-score of -0.86 (19.4th percentile), this represents normal volume ; hippocampal volume measures 7,342 mm³, 3.2% above the reference mean. With a Z-score of 0.29 (61.5th percentile), this represents normal volume ; whole brain volume measures 1,010,570 mm³, 3.7% above the reference mean. With a Z-score of 0.46 (67.9th percentile), this represents normal volume ; entorhinal cortex volume measures 2,593 mm³, 29.4% below the reference mean. With a Z-score of -1.80 (3.6th percentile), this represents moderate atrophy; fusiform gyrus volume measures 16,590 mm³, 2.5% below the reference mean. With a Z-score of -0.23 (41.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,197 mm³, 15.5% below the reference mean. With a Z-score of -1.35 (8.9th percentile), this represents mild atrophy. ",
  "text_data": "Age is 73.5 years. Gender is Female. Education: 12 years. MMSE: 24.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows moderate atrophy (Z-score -1.80, 3.6th percentile), and the middle temporal gyrus shows mild atrophy (Z-score -1.35, 8.9th percentile), both of which are early markers of Alzheimer's pathology. However, hippocampal and whole brain volumes are normal, and the MMSE score of 24 is borderline (mild cognitive impairment range). The presence of one APOE4 allele increases Alzheimer's risk but does not confirm it.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting markers—some atrophy in key regions but preserved hippocampal volume and borderline MMSE).",
  "timestamp": "2025-07-26T16:50:31.940880"
}