{
  "ptid_time": "016_S_1092_2009-12-15",
  "img_path": "/data/qiuhui/data/adni/images/016_S_1092/2009-12-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 16,611 mm³, 56.9% below the reference mean. With a Z-score of -1.36 (8.7th percentile), this represents mild atrophy; hippocampal volume measures 6,708 mm³, 11.3% below the reference mean. With a Z-score of -1.10 (13.6th percentile), this represents mild atrophy; whole brain volume measures 914,285 mm³, 15.3% below the reference mean. With a Z-score of -1.99 (2.4th percentile), this represents moderate atrophy; entorhinal cortex volume measures 3,132 mm³, 23.6% below the reference mean. With a Z-score of -1.60 (5.5th percentile), this represents moderate atrophy; fusiform gyrus volume measures 17,567 mm³, 6.7% below the reference mean. With a Z-score of -0.57 (28.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,767 mm³, 12.1% below the reference mean. With a Z-score of -1.08 (13.9th percentile), this represents mild atrophy. ",
  "text_data": "Age is 77.3 years. Gender is Male. Education: 16 years. MMSE: 24.0. Logical Memory: 7.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows moderate atrophy in whole brain and entorhinal cortex volumes, along with mild atrophy in hippocampal and middle temporal gyrus volumes, which are key regions affected in Alzheimer's disease. The MMSE score of 24 suggests mild cognitive impairment, and the presence of two APOE4 alleles increases Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s disease given atrophy pattern and APOE4 status)  \n\n**Confidence:** **Medium** (clinical correlation needed to rule out other causes of atrophy, but imaging and genetic risk strongly suggest early neurodegenerative pathology).",
  "timestamp": "2025-07-26T00:12:25.506606"
}