{
  "ptid_time": "052_S_0989_2006-11-14",
  "img_path": "/data/qiuhui/data/adni/images/052_S_0989/2006-11-14/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 30,211 mm³, 35.3% above the reference mean. With a Z-score of 0.88 (81.1th percentile), this represents normal volume ; hippocampal volume measures 6,554 mm³, 14.7% below the reference mean. With a Z-score of -1.65 (4.9th percentile), this represents moderate atrophy; whole brain volume measures 923,074 mm³, 10.3% below the reference mean. With a Z-score of -1.28 (10.0th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,460 mm³, 11.1% below the reference mean. With a Z-score of -0.86 (19.4th percentile), this represents normal volume ; fusiform gyrus volume measures 15,210 mm³, 16.5% below the reference mean. With a Z-score of -1.86 (3.2th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 20,462 mm³, 0.3% below the reference mean. With a Z-score of -0.02 (49.0th percentile), this represents normal volume . ",
  "text_data": "Age is 64.3 years. Gender is Female. Education: 13 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Hematopoietic-Lymphatic; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 28.0. Logical Memory: 8.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows moderate atrophy in the hippocampus and fusiform gyrus, which are key regions affected in Alzheimer's disease (AD), along with mild whole-brain atrophy. However, MMSE is normal (28/30), and entorhinal cortex and ventricular volumes are within normal limits, suggesting preserved cognitive function despite structural changes.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (given significant hippocampal atrophy but intact global cognition).  \n\n**Confidence:** **Medium** (structural changes suggest neurodegeneration, but clinical cognitive performance is still normal, making early AD also possible).",
  "timestamp": "2025-07-26T07:42:10.403456"
}