{
  "ptid_time": "067_S_0176_2009-05-04",
  "img_path": "/data/qiuhui/data/adni/images/067_S_0176/2009-05-04/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 42,462 mm³, 10.2% above the reference mean. With a Z-score of 0.25 (59.7th percentile), this represents normal volume ; hippocampal volume measures 5,366 mm³, 29.0% below the reference mean. With a Z-score of -2.83 (0.2th percentile), this represents significant atrophy; whole brain volume measures 1,014,040 mm³, 6.1% below the reference mean. With a Z-score of -0.79 (21.6th percentile), this represents normal volume ; entorhinal cortex volume measures 2,476 mm³, 39.6% below the reference mean. With a Z-score of -2.69 (0.4th percentile), this represents significant atrophy; fusiform gyrus volume measures 16,263 mm³, 13.7% below the reference mean. With a Z-score of -1.16 (12.2th percentile), this represents mild atrophy; middle temporal gyrus volume measures 19,523 mm³, 8.5% below the reference mean. With a Z-score of -0.77 (22.2th percentile), this represents normal volume . ",
  "text_data": "Age is 77.7 years. Gender is Male. Education: 19 years. MMSE: 27.0. Logical Memory: 5.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant atrophy in the hippocampus (-2.83 Z-score) and entorhinal cortex (-2.69 Z-score), both key regions affected in Alzheimer's disease, while other brain volumes remain largely normal. The MMSE score of 27 is within the normal range, but the structural changes suggest early neurodegeneration.  \n**Diagnosis:** Mild Cognitive Impairment (MCI)  \n**Confidence:** Medium (due to normal MMSE but strong structural evidence of atrophy in AD-vulnerable regions)",
  "timestamp": "2025-07-26T08:26:37.352776"
}