{
  "ptid_time": "003_S_1057_2008-02-08",
  "img_path": "/data/qiuhui/data/adni/images/003_S_1057/2008-02-08/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 19,193 mm³, 14.1% below the reference mean. With a Z-score of -0.35 (36.2th percentile), this represents normal volume ; hippocampal volume measures 6,043 mm³, 21.4% below the reference mean. With a Z-score of -2.40 (0.8th percentile), this represents significant atrophy; whole brain volume measures 932,761 mm³, 9.4% below the reference mean. With a Z-score of -1.17 (12.2th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,266 mm³, 16.1% below the reference mean. With a Z-score of -1.25 (10.6th percentile), this represents mild atrophy; fusiform gyrus volume measures 15,763 mm³, 13.4% below the reference mean. With a Z-score of -1.51 (6.5th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 20,107 mm³, 2.0% below the reference mean. With a Z-score of -0.18 (42.9th percentile), this represents normal volume . ",
  "text_data": "Age is 62.2 years. Gender is Female. Education: 18 years. MMSE: 28.0. Logical Memory: 5.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "Reasoning: The hippocampal volume shows significant atrophy (Z-score -2.40, 0.8th percentile), which is strongly associated with Alzheimer's pathology. Other regions (whole brain, entorhinal cortex, fusiform gyrus) also show mild to moderate atrophy, while ventricular volume and middle temporal gyrus are normal. The MMSE score of 28 is within normal limits, but structural changes suggest early neurodegeneration. APOE4 homozygosity (2 alleles) further increases Alzheimer's risk.  \n\nDiagnosis: **MCI** (likely prodromal Alzheimer's given hippocampal atrophy and APOE4 status, but preserved MMSE prevents dementia diagnosis)  \nConfidence: **Medium** (clear structural changes but lack of clinical cognitive impairment limits certainty)",
  "timestamp": "2025-07-25T20:43:03.871350"
}