{
  "ptid_time": "100_S_0995_2006-10-27",
  "img_path": "/data/qiuhui/data/adni/images/100_S_0995/2006-10-27/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 28,639 mm³, 2.0% above the reference mean. With a Z-score of 0.05 (51.9th percentile), this represents normal volume ; hippocampal volume measures 5,222 mm³, 26.6% below the reference mean. With a Z-score of -2.44 (0.7th percentile), this represents significant atrophy; whole brain volume measures 980,848 mm³, 0.6% above the reference mean. With a Z-score of 0.08 (53.2th percentile), this represents normal volume ; entorhinal cortex volume measures 2,797 mm³, 23.8% below the reference mean. With a Z-score of -1.46 (7.2th percentile), this represents mild atrophy; fusiform gyrus volume measures 17,537 mm³, 3.1% above the reference mean. With a Z-score of 0.28 (61.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,076 mm³, 0.5% below the reference mean. With a Z-score of -0.04 (48.3th percentile), this represents normal volume . ",
  "text_data": "Age is 78.5 years. Gender is Female. Education: 12 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Allergies or Drug Sensitivities; Malignancy; Major Surgical Procedures. MMSE: 26.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows significant atrophy (Z-score -2.44, 0.7th percentile), and the entorhinal cortex exhibits mild atrophy (Z-score -1.46, 7.2th percentile), both key regions in Alzheimer's pathology. Despite a normal MMSE (26/30), the structural changes suggest neurodegeneration.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely amnestic subtype given hippocampal involvement).  \n**Confidence:** **Medium** (clinical correlation needed to rule out other causes of hippocampal atrophy, but imaging strongly suggests early neurodegenerative disease).  \n\n*Note:* APOE4 positivity increases Alzheimer’s risk but isn’t diagnostic. Follow-up with CSF biomarkers or amyloid PET could clarify etiology.",
  "timestamp": "2025-07-26T11:20:37.098396"
}