{
  "ptid_time": "005_S_0324_2009-06-01",
  "img_path": "/data/qiuhui/data/adni/images/005_S_0324/2009-06-01/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 18,755 mm³, 33.2% below the reference mean. With a Z-score of -0.76 (22.4th percentile), this represents normal volume ; hippocampal volume measures 4,645 mm³, 34.7% below the reference mean. With a Z-score of -3.18 (0.1th percentile), this represents profound atrophy; whole brain volume measures 868,760 mm³, 10.9% below the reference mean. With a Z-score of -1.37 (8.6th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,175 mm³, 40.8% below the reference mean. With a Z-score of -2.50 (0.6th percentile), this represents significant atrophy; fusiform gyrus volume measures 11,035 mm³, 35.1% below the reference mean. With a Z-score of -3.20 (0.1th percentile), this represents profound atrophy; middle temporal gyrus volume measures 13,276 mm³, 30.7% below the reference mean. With a Z-score of -2.67 (0.4th percentile), this represents significant atrophy. ",
  "text_data": "Age is 78.3 years. Gender is Female. Education: 14 years. MMSE: 26.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows profound atrophy in the hippocampus, entorhinal cortex, fusiform gyrus, and middle temporal gyrus—key regions affected in Alzheimer's disease. Despite a normal MMSE score (26/30), the severe atrophy in memory-related structures suggests neurodegeneration, though the absence of APOE4 may indicate a non-genetic form.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given the atrophy pattern, but clinical symptoms are not yet severe enough for dementia).  \n\n**Confidence:** **Medium** (high confidence in neurodegeneration, but MCI diagnosis relies on clinical correlation; MMSE is borderline normal, and lack of functional decline per available data limits certainty).",
  "timestamp": "2025-07-25T21:05:54.856866"
}