{
  "ptid_time": "023_S_0081_2008-01-25",
  "img_path": "/data/qiuhui/data/adni/images/023_S_0081/2008-01-25/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 46,960 mm³, 21.9% above the reference mean. With a Z-score of 0.53 (70.0th percentile), this represents normal volume ; hippocampal volume measures 6,335 mm³, 16.2% below the reference mean. With a Z-score of -1.58 (5.7th percentile), this represents moderate atrophy; whole brain volume measures 944,133 mm³, 12.5% below the reference mean. With a Z-score of -1.63 (5.2th percentile), this represents moderate atrophy; entorhinal cortex volume measures 4,340 mm³, 5.8% above the reference mean. With a Z-score of 0.40 (65.4th percentile), this represents normal volume ; fusiform gyrus volume measures 16,970 mm³, 9.9% below the reference mean. With a Z-score of -0.84 (19.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,240 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 72.6 years. Gender is Male. Education: 18 years. MMSE: 29.0. Logical Memory: 17.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal and whole brain volumes show moderate atrophy (Z-scores of -1.58 and -1.63, respectively), which are concerning for neurodegenerative changes. However, the MMSE score of 29 is within the normal range, and other key regions (entorhinal cortex, fusiform gyrus, middle temporal gyrus) are normal. The presence of one APOE4 allele increases Alzheimer's risk but does not confirm pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Structural atrophy suggests early neurodegeneration, but cognitive performance remains intact, making dementia unlikely at this stage.)",
  "timestamp": "2025-07-26T02:34:27.996907"
}