{
  "ptid_time": "033_S_1284_2007-08-20",
  "img_path": "/data/qiuhui/data/adni/images/033_S_1284/2007-08-20/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 70,323 mm³, 49.6% above the reference mean. With a Z-score of 1.44 (92.5th percentile), this represents mild enlargement; hippocampal volume measures 6,236 mm³, 10.5% below the reference mean. With a Z-score of -0.91 (18.2th percentile), this represents normal volume ; whole brain volume measures 995,177 mm³, 3.3% below the reference mean. With a Z-score of -0.43 (33.3th percentile), this represents normal volume ; entorhinal cortex volume measures 2,485 mm³, 37.4% below the reference mean. With a Z-score of -2.45 (0.7th percentile), this represents significant atrophy; fusiform gyrus volume measures 17,503 mm³, 3.1% below the reference mean. With a Z-score of -0.27 (39.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 15,680 mm³, 22.3% below the reference mean. With a Z-score of -2.00 (2.3th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 86.4 years. Gender is Male. Education: 16 years. MMSE: 29.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant atrophy in the entorhinal cortex (Z-score -2.45) and moderate atrophy in the middle temporal gyrus (Z-score -2.00), both key regions in Alzheimer's pathology. Despite normal hippocampal and whole-brain volumes, these focal atrophies, along with mild ventricular enlargement, suggest early neurodegenerative changes. The high MMSE (29/30) indicates preserved cognitive function, but structural changes raise concern.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (High-risk profile due to APOE4 and focal atrophy, but MMSE is still intact, requiring longitudinal follow-up.)",
  "timestamp": "2025-07-26T05:33:00.580934"
}