{
  "ptid_time": "031_S_0568_2006-12-05",
  "img_path": "/data/qiuhui/data/adni/images/031_S_0568/2006-12-05/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 31,739 mm³, 14.1% below the reference mean. With a Z-score of -0.38 (35.1th percentile), this represents normal volume ; hippocampal volume measures 5,007 mm³, 22.9% below the reference mean. With a Z-score of -1.84 (3.3th percentile), this represents moderate atrophy; whole brain volume measures 930,491 mm³, 0.2% above the reference mean. With a Z-score of 0.03 (51.2th percentile), this represents normal volume ; entorhinal cortex volume measures 2,258 mm³, 34.8% below the reference mean. With a Z-score of -1.88 (3.0th percentile), this represents moderate atrophy; fusiform gyrus volume measures 14,247 mm³, 11.6% below the reference mean. With a Z-score of -0.87 (19.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,888 mm³, 0.8% below the reference mean. With a Z-score of -0.07 (47.2th percentile), this represents normal volume . ",
  "text_data": "Age is 80.3 years. Gender is Female. Education: 16 years. MMSE: 23.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows moderate atrophy in the hippocampus and entorhinal cortex (both in the 3rd percentile), which are key regions affected in Alzheimer's disease. The MMSE score of 23 suggests mild cognitive impairment, and the absence of APOE4 reduces but does not eliminate Alzheimer's risk. Other brain regions are within normal ranges.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer's pathology given hippocampal/entorhinal atrophy).  \n\n**Confidence:** **Medium** (clear structural changes but no biomarker confirmation like amyloid/tau PET or CSF).",
  "timestamp": "2025-07-26T04:36:42.494645"
}