{
  "ptid_time": "041_S_0282_2007-02-08",
  "img_path": "/data/qiuhui/data/adni/images/041_S_0282/2007-02-08/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 16,374 mm³, 57.5% below the reference mean. With a Z-score of -1.38 (8.4th percentile), this represents mild atrophy; hippocampal volume measures 8,114 mm³, 7.3% above the reference mean. With a Z-score of 0.72 (76.3th percentile), this represents normal volume ; whole brain volume measures 904,789 mm³, 16.2% below the reference mean. With a Z-score of -2.10 (1.8th percentile), this represents significant atrophy; entorhinal cortex volume measures 3,599 mm³, 12.2% below the reference mean. With a Z-score of -0.83 (20.3th percentile), this represents normal volume ; fusiform gyrus volume measures 17,874 mm³, 5.1% below the reference mean. With a Z-score of -0.44 (33.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,004 mm³, 20.3% below the reference mean. With a Z-score of -1.83 (3.4th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 72.6 years. Gender is Male. Education: 20 years. MMSE: 27.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant whole-brain atrophy (Z-score -2.10, 1.8th percentile) and moderate atrophy in the middle temporal gyrus (Z-score -1.83, 3.4th percentile), which are concerning for neurodegenerative changes. However, hippocampal volume is normal (Z-score 0.72, 76.3th percentile), and MMSE is within normal limits (27/30), suggesting preserved cognitive function.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (due to structural atrophy but intact cognition)  \n**Confidence:** **Medium** (atrophy is present, but cognitive performance is normal, and APOE4-negative status reduces Alzheimer’s risk)",
  "timestamp": "2025-07-26T06:56:58.660108"
}