{
  "ptid_time": "013_S_0575_2008-09-15",
  "img_path": "/data/qiuhui/data/adni/images/013_S_0575/2008-09-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 66,172 mm³, 79.0% above the reference mean. With a Z-score of 2.13 (98.4th percentile), this represents significant enlargement; hippocampal volume measures 5,227 mm³, 19.5% below the reference mean. With a Z-score of -1.56 (5.9th percentile), this represents moderate atrophy; whole brain volume measures 886,142 mm³, 4.5% below the reference mean. With a Z-score of -0.54 (29.3th percentile), this represents normal volume ; entorhinal cortex volume measures 2,203 mm³, 36.4% below the reference mean. With a Z-score of -1.96 (2.5th percentile), this represents moderate atrophy; fusiform gyrus volume measures 13,015 mm³, 19.2% below the reference mean. With a Z-score of -1.44 (7.4th percentile), this represents mild atrophy; middle temporal gyrus volume measures 15,318 mm³, 15.0% below the reference mean. With a Z-score of -1.34 (9.0th percentile), this represents mild atrophy. ",
  "text_data": "Age is 88.2 years. Gender is Female. Education: 17 years. MMSE: 29.0. Logical Memory: 15.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant ventricular enlargement (98.4th percentile) and moderate atrophy in the hippocampus (5.9th percentile) and entorhinal cortex (2.5th percentile), which are hallmark features of Alzheimer's pathology. However, the MMSE score of 29 is within the normal range, and the absence of APOE4 alleles reduces genetic risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (given structural changes despite intact cognition)  \n**Confidence:** **Medium** (high confidence in structural abnormalities, but clinical symptoms do not yet meet dementia criteria).",
  "timestamp": "2025-07-25T23:22:18.826453"
}