{
  "ptid_time": "029_S_0878_2007-10-31",
  "img_path": "/data/qiuhui/data/adni/images/029_S_0878/2007-10-31/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 28,869 mm³, 25.0% below the reference mean. With a Z-score of -0.60 (27.4th percentile), this represents normal volume ; hippocampal volume measures 6,311 mm³, 16.5% below the reference mean. With a Z-score of -1.61 (5.4th percentile), this represents moderate atrophy; whole brain volume measures 1,017,850 mm³, 5.7% below the reference mean. With a Z-score of -0.74 (23.0th percentile), this represents normal volume ; entorhinal cortex volume measures 3,825 mm³, 6.7% below the reference mean. With a Z-score of -0.46 (32.4th percentile), this represents normal volume ; fusiform gyrus volume measures 17,530 mm³, 6.9% below the reference mean. With a Z-score of -0.59 (27.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 13,130 mm³, 38.5% below the reference mean. With a Z-score of -3.46 (0.0th percentile), this represents profound atrophy. ",
  "text_data": "Age is 73.3 years. Gender is Male. Education: 14 years. MMSE: 25.0. Logical Memory: 3.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows moderate atrophy (Z-score -1.61, 5.4th percentile), and the middle temporal gyrus exhibits profound atrophy (Z-score -3.46, 0.0th percentile), both of which are strongly associated with Alzheimer's pathology. The MMSE score of 25 is borderline but still within the mild cognitive impairment (MCI) range. The presence of one APOE4 allele further increases Alzheimer's risk.  \n\n**Diagnosis:** **MCI (likely due to Alzheimer’s disease)**  \n**Confidence:** **Medium** (due to the presence of significant atrophy in key regions but lack of severe cognitive decline on MMSE)",
  "timestamp": "2025-07-26T04:19:22.864579"
}