{
  "ptid_time": "137_S_1426_2007-09-07",
  "img_path": "/data/qiuhui/data/adni/images/137_S_1426/2007-09-07/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 140,133 mm³, 198.1% above the reference mean. With a Z-score of 5.75 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 6,296 mm³, 9.6% below the reference mean. With a Z-score of -0.83 (20.2th percentile), this represents normal volume ; whole brain volume measures 1,065,330 mm³, 3.5% above the reference mean. With a Z-score of 0.46 (67.7th percentile), this represents normal volume ; entorhinal cortex volume measures 2,298 mm³, 42.1% below the reference mean. With a Z-score of -2.76 (0.3th percentile), this represents significant atrophy; fusiform gyrus volume measures 13,587 mm³, 24.8% below the reference mean. With a Z-score of -2.15 (1.6th percentile), this represents significant atrophy; middle temporal gyrus volume measures 20,681 mm³, 2.5% above the reference mean. With a Z-score of 0.23 (59.0th percentile), this represents normal volume . ",
  "text_data": "Age is 83.4 years. Gender is Male. Education: 18 years. MMSE: 26.0. Logical Memory: 6.0. APOEε4 alleles: 0.0. Biomarker levels: Pittsburgh compound B: 1.81 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant atrophy in the entorhinal cortex and fusiform gyrus, both critical regions for memory and cognitive function, alongside profound ventricular enlargement (suggesting widespread atrophy). However, hippocampal volume is relatively preserved, and MMSE is within normal limits (26/30). The absence of APOE4 reduces genetic risk but does not rule out neurodegeneration.  \n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (structural changes are pronounced, but cognitive screening is borderline normal for age).  \n**Confidence:** **Medium** (MMSE is near-normal, but structural atrophy strongly suggests early neurodegeneration).  \n\n*Note: A more detailed neuropsychological exam (e.g., MoCA, episodic memory tests) would help clarify if this meets dementia criteria.*",
  "timestamp": "2025-07-26T16:27:33.443459"
}