{
  "ptid_time": "130_S_0449_2007-02-26",
  "img_path": "/data/qiuhui/data/adni/images/130_S_0449/2007-02-26/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 23,083 mm³, 3.3% above the reference mean. With a Z-score of 0.08 (53.3th percentile), this represents normal volume ; hippocampal volume measures 5,596 mm³, 27.2% below the reference mean. With a Z-score of -3.05 (0.1th percentile), this represents profound atrophy; whole brain volume measures 982,293 mm³, 4.6% below the reference mean. With a Z-score of -0.57 (28.5th percentile), this represents normal volume ; entorhinal cortex volume measures 2,700 mm³, 30.6% below the reference mean. With a Z-score of -2.37 (0.9th percentile), this represents significant atrophy; fusiform gyrus volume measures 17,429 mm³, 4.3% below the reference mean. With a Z-score of -0.48 (31.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,431 mm³, 10.2% below the reference mean. With a Z-score of -0.90 (18.3th percentile), this represents normal volume . ",
  "text_data": "Age is 67.0 years. Gender is Female. Education: 14 years. MMSE: 29.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound atrophy in the hippocampus (-3.05 Z-score) and significant atrophy in the entorhinal cortex (-2.37 Z-score), both key regions affected in Alzheimer's disease. Despite normal MMSE (29/30) and no significant whole-brain atrophy, the severe medial temporal lobe atrophy in an APOE4 homozygous individual strongly suggests early neurodegenerative changes.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**, likely prodromal Alzheimer’s disease.  \n\n**Confidence:** **High** (due to the combination of hippocampal/entorhinal atrophy and APOE4 homozygosity, despite normal MMSE).",
  "timestamp": "2025-07-26T14:28:44.128311"
}