{
  "ptid_time": "009_S_0862_2006-09-19",
  "img_path": "/data/qiuhui/data/adni/images/009_S_0862/2006-09-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 21,696 mm³, 22.7% below the reference mean. With a Z-score of -0.52 (30.2th percentile), this represents normal volume ; hippocampal volume measures 6,327 mm³, 11.1% below the reference mean. With a Z-score of -1.02 (15.5th percentile), this represents mild atrophy; whole brain volume measures 926,122 mm³, 5.0% below the reference mean. With a Z-score of -0.63 (26.5th percentile), this represents normal volume ; entorhinal cortex volume measures 2,832 mm³, 22.9% below the reference mean. With a Z-score of -1.41 (8.0th percentile), this represents mild atrophy; fusiform gyrus volume measures 15,157 mm³, 10.9% below the reference mean. With a Z-score of -0.99 (16.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,496 mm³, 6.9% above the reference mean. With a Z-score of 0.60 (72.6th percentile), this represents normal volume . ",
  "text_data": "Age is 73.4 years. Gender is Female. Education: 12 years. Handedness: Right. Race: White. Medical history: Psychiatric; Cardiovascular; Respiratory; Musculoskeletal; Endocrine-Metabolic; Renal-Genitourinary; Smoking; Major Surgical Procedures. MMSE: 30.0. Logical Memory: 14.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal and entorhinal cortex volumes show mild atrophy (Z-scores -1.02 and -1.41, respectively), which are early markers of Alzheimer's pathology. However, the MMSE score of 30 is intact, and other brain regions (ventricular, whole brain, fusiform gyrus, middle temporal gyrus) are within normal ranges. 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 changes suggest early neurodegeneration, but cognitive performance remains normal, making progression uncertain.)",
  "timestamp": "2025-07-25T22:13:26.402412"
}