{
  "ptid_time": "128_S_0230_2007-03-22",
  "img_path": "/data/qiuhui/data/adni/images/128_S_0230/2007-03-22/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 41,076 mm³, 12.6% below the reference mean. With a Z-score of -0.37 (35.7th percentile), this represents normal volume ; hippocampal volume measures 5,787 mm³, 17.0% below the reference mean. With a Z-score of -1.46 (7.2th percentile), this represents mild atrophy; whole brain volume measures 1,064,480 mm³, 3.4% above the reference mean. With a Z-score of 0.45 (67.4th percentile), this represents normal volume ; entorhinal cortex volume measures 2,510 mm³, 36.8% below the reference mean. With a Z-score of -2.41 (0.8th percentile), this represents significant atrophy; fusiform gyrus volume measures 16,898 mm³, 6.5% below the reference mean. With a Z-score of -0.56 (28.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,972 mm³, 8.9% above the reference mean. With a Z-score of 0.80 (78.8th percentile), this represents normal volume . ",
  "text_data": "Age is 81.0 years. Gender is Male. Education: 20 years. MMSE: 30.0. Logical Memory: 8.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.46, 7.2th percentile), and the entorhinal cortex exhibits significant atrophy (Z-score -2.41, 0.8th percentile), both of which are early markers of Alzheimer's pathology. However, the MMSE score of 30 is intact, and other brain regions (ventricular, whole brain, fusiform gyrus, middle temporal gyrus) are within normal ranges.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting biomarkers—structural atrophy in key regions but preserved cognitive function on MMSE)",
  "timestamp": "2025-07-26T13:41:32.991246"
}