{
  "ptid_time": "041_S_0721_2007-03-12",
  "img_path": "/data/qiuhui/data/adni/images/041_S_0721/2007-03-12/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 26,372 mm³, 12.2% below the reference mean. With a Z-score of -0.29 (38.6th percentile), this represents normal volume ; hippocampal volume measures 6,287 mm³, 21.7% below the reference mean. With a Z-score of -2.17 (1.5th percentile), this represents significant atrophy; whole brain volume measures 925,566 mm³, 18.4% below the reference mean. With a Z-score of -2.61 (0.5th percentile), this represents significant atrophy; entorhinal cortex volume measures 3,957 mm³, 7.2% below the reference mean. With a Z-score of -0.50 (31.0th percentile), this represents normal volume ; fusiform gyrus volume measures 16,154 mm³, 18.9% below the reference mean. With a Z-score of -1.57 (5.8th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 14,598 mm³, 34.9% below the reference mean. With a Z-score of -2.87 (0.2th percentile), this represents significant atrophy. ",
  "text_data": "Age is 66.8 years. Gender is Male. Education: 20 years. MMSE: 28.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in the hippocampus, whole brain, and middle temporal gyrus, which are key regions affected in Alzheimer's disease (AD). However, the MMSE score of 28 is within the normal range, suggesting preserved cognitive function despite structural changes. The presence of two APOE4 alleles increases AD risk but does not confirm diagnosis alone.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (due to significant structural atrophy with normal cognition)  \n**Confidence:** **Medium** (high structural evidence but normal MMSE complicates full dementia diagnosis)",
  "timestamp": "2025-07-26T07:01:37.153751"
}