{
  "ptid_time": "003_S_1122_2008-07-03",
  "img_path": "/data/qiuhui/data/adni/images/003_S_1122/2008-07-03/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 18,901 mm³, 32.7% below the reference mean. With a Z-score of -0.75 (22.7th percentile), this represents normal volume ; hippocampal volume measures 7,809 mm³, 9.8% above the reference mean. With a Z-score of 0.90 (81.5th percentile), this represents normal volume ; whole brain volume measures 751,121 mm³, 22.9% below the reference mean. With a Z-score of -2.89 (0.2th percentile), this represents significant atrophy; entorhinal cortex volume measures 3,049 mm³, 17.0% below the reference mean. With a Z-score of -1.04 (14.9th percentile), this represents mild atrophy; fusiform gyrus volume measures 10,576 mm³, 37.8% below the reference mean. With a Z-score of -3.44 (0.0th percentile), this represents profound atrophy; middle temporal gyrus volume measures 15,554 mm³, 18.9% below the reference mean. With a Z-score of -1.64 (5.1th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 78.1 years. Gender is Female. Education: 14 years. MMSE: 29.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient exhibits significant atrophy in whole brain volume (Z-score -2.89) and profound atrophy in the fusiform gyrus (Z-score -3.44), with moderate atrophy in the middle temporal gyrus and mild atrophy in the entorhinal cortex. However, hippocampal volume is normal (Z-score 0.90), and MMSE is intact (29/30). The absence of APOE4 and preserved hippocampal volume suggest a less typical Alzheimer's pattern.  \n**Diagnosis:** **MCI** (structural changes are concerning but cognitive function remains largely intact).  \n**Confidence:** **Medium** (discrepancy between structural atrophy and cognitive performance warrants caution",
  "timestamp": "2025-07-25T20:45:52.887664"
}