{
  "ptid_time": "094_S_0434_2006-11-10",
  "img_path": "/data/qiuhui/data/adni/images/094_S_0434/2006-11-10/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 33,556 mm³, 12.9% below the reference mean. With a Z-score of -0.31 (37.9th percentile), this represents normal volume ; hippocampal volume measures 6,117 mm³, 19.1% below the reference mean. With a Z-score of -1.86 (3.1th percentile), this represents moderate atrophy; whole brain volume measures 979,612 mm³, 9.2% below the reference mean. With a Z-score of -1.20 (11.5th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,419 mm³, 16.6% below the reference mean. With a Z-score of -1.13 (13.0th percentile), this represents mild atrophy; fusiform gyrus volume measures 16,353 mm³, 13.2% below the reference mean. With a Z-score of -1.12 (13.1th percentile), this represents mild atrophy; middle temporal gyrus volume measures 12,734 mm³, 40.3% below the reference mean. With a Z-score of -3.62 (0.0th percentile), this represents profound atrophy. ",
  "text_data": "Age is 72.2 years. Gender is Male. Education: 20 years. MMSE: 26.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows moderate atrophy (Z-score -1.86, 3.1th percentile), and the middle temporal gyrus exhibits profound atrophy (Z-score -3.62, 0.0th percentile), both strongly associated with Alzheimer's pathology. The MMSE score of 26 is borderline but still within the normal range, suggesting possible early cognitive impairment. The presence of an APOE4 allele increases Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s disease given the atrophy pattern).  \n\n**Confidence:** **Medium** (clinical correlation needed—neuropsychological testing or CSF/PET biomarkers would strengthen confidence).",
  "timestamp": "2025-07-26T10:10:58.762704"
}