{
  "ptid_time": "032_S_0187_2006-02-13",
  "img_path": "/data/qiuhui/data/adni/images/032_S_0187/2006-02-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 31,534 mm³, 18.1% below the reference mean. With a Z-score of -0.43 (33.2th percentile), this represents normal volume ; hippocampal volume measures 5,916 mm³, 21.7% below the reference mean. With a Z-score of -2.12 (1.7th percentile), this represents significant atrophy; whole brain volume measures 972,549 mm³, 9.9% below the reference mean. With a Z-score of -1.28 (9.9th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,259 mm³, 20.5% below the reference mean. With a Z-score of -1.39 (8.2th percentile), this represents mild atrophy; fusiform gyrus volume measures 15,924 mm³, 15.5% below the reference mean. With a Z-score of -1.32 (9.4th percentile), this represents mild atrophy; middle temporal gyrus volume measures 17,840 mm³, 16.4% below the reference mean. With a Z-score of -1.47 (7.0th percentile), this represents mild atrophy. ",
  "text_data": "Age is 77.1 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Endocrine-Metabolic; Gastrointestinal; Allergies or Drug Sensitivities; Smoking. MMSE: 28.0. Logical Memory: 3.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows significant atrophy (Z-score -2.12, 1.7th percentile), which is a strong biomarker for Alzheimer's disease. Other regions (entorhinal cortex, fusiform gyrus, middle temporal gyrus) also exhibit mild atrophy, while ventricular volume is normal. Despite the high MMSE score (28/30), the structural changes suggest early neurodegeneration.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given hippocampal atrophy and APOE4 homozygosity).  \n\n**Confidence:** **Medium** (MMSE is near-normal, but imaging strongly suggests early pathology).",
  "timestamp": "2025-07-26T04:52:24.631552"
}