{
  "ptid_time": "057_S_1269_2007-08-22",
  "img_path": "/data/qiuhui/data/adni/images/057_S_1269/2007-08-22/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 42,045 mm³, 9.2% above the reference mean. With a Z-score of 0.22 (58.7th percentile), this represents normal volume ; hippocampal volume measures 6,778 mm³, 10.3% below the reference mean. With a Z-score of -1.01 (15.7th percentile), this represents mild atrophy; whole brain volume measures 1,031,730 mm³, 4.4% below the reference mean. With a Z-score of -0.57 (28.3th percentile), this represents normal volume ; entorhinal cortex volume measures 4,989 mm³, 21.7% above the reference mean. With a Z-score of 1.47 (92.9th percentile), this represents mild enlargement; fusiform gyrus volume measures 16,864 mm³, 10.5% below the reference mean. With a Z-score of -0.89 (18.6th percentile), this represents normal volume ; middle temporal gyrus volume measures 24,279 mm³, 13.8% above the reference mean. With a Z-score of 1.24 (89.2th percentile), this represents mild enlargement. ",
  "text_data": "Age is 73.9 years. Gender is Male. Education: 20 years. MMSE: 28.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.01, 15.7th percentile), which is a key biomarker for Alzheimer's pathology, while other regions are either normal or mildly enlarged. The MMSE score of 28 is within the normal range, and the absence of APOE4 reduces genetic risk. However, hippocampal atrophy suggests early neurodegenerative changes.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to hippocampal atrophy but preserved cognitive function on MMSE)",
  "timestamp": "2025-07-26T08:10:37.878255"
}