{
  "ptid_time": "021_S_0642_2006-06-28",
  "img_path": "/data/qiuhui/data/adni/images/021_S_0642/2006-06-28/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 60,100 mm³, 27.8% above the reference mean. With a Z-score of 0.81 (79.1th percentile), this represents normal volume ; hippocampal volume measures 6,210 mm³, 10.9% below the reference mean. With a Z-score of -0.94 (17.4th percentile), this represents normal volume ; whole brain volume measures 954,368 mm³, 7.3% below the reference mean. With a Z-score of -0.95 (17.0th percentile), this represents normal volume ; entorhinal cortex volume measures 2,389 mm³, 39.8% below the reference mean. With a Z-score of -2.61 (0.5th percentile), this represents significant atrophy; fusiform gyrus volume measures 14,428 mm³, 20.1% below the reference mean. With a Z-score of -1.74 (4.1th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 14,983 mm³, 25.7% below the reference mean. With a Z-score of -2.31 (1.1th percentile), this represents significant atrophy. ",
  "text_data": "Age is 84.5 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Psychiatric; Cardiovascular; Hematopoietic-Lymphatic; Allergies or Drug Sensitivities. MMSE: 25.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex, fusiform gyrus, and middle temporal gyrus show significant to moderate atrophy, which are key regions affected in Alzheimer's disease. Despite normal hippocampal and whole-brain volumes, the focal atrophy in these regions, along with borderline MMSE (25/30) in an 84.5-year-old male, suggests early cognitive decline.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely amnestic subtype given entorhinal atrophy)  \n\n**Confidence:** **Medium** (Clinical correlation with neuropsychological testing would strengthen confidence, but imaging findings are concerning for early neurodegeneration.)",
  "timestamp": "2025-07-26T01:33:33.079247"
}