{
  "ptid_time": "003_S_1057_2007-10-23",
  "img_path": "/data/qiuhui/data/adni/images/003_S_1057/2007-10-23/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 17,942 mm³, 19.7% below the reference mean. With a Z-score of -0.49 (31.1th percentile), this represents normal volume ; hippocampal volume measures 6,504 mm³, 15.4% below the reference mean. With a Z-score of -1.72 (4.2th percentile), this represents moderate atrophy; whole brain volume measures 939,554 mm³, 8.7% below the reference mean. With a Z-score of -1.08 (13.9th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,151 mm³, 19.1% below the reference mean. With a Z-score of -1.48 (7.0th percentile), this represents mild atrophy; fusiform gyrus volume measures 15,217 mm³, 16.4% below the reference mean. With a Z-score of -1.85 (3.2th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 20,511 mm³, 0.0% below the reference mean. With a Z-score of -0.00 (49.9th percentile), this represents normal volume . ",
  "text_data": "Age is 61.7 years. Gender is Female. Education: 18 years. MMSE: 25.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows moderate atrophy in the hippocampus and fusiform gyrus, along with mild atrophy in the whole brain and entorhinal cortex, which are key regions affected in Alzheimer's disease. The MMSE score of 25 is borderline, and the presence of two APOE4 alleles increases genetic risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given biomarker profile)  \n**Confidence:** **Medium** (clinical correlation needed to rule out other causes of atrophy)",
  "timestamp": "2025-07-25T20:42:55.906819"
}