{
  "ptid_time": "024_S_0985_2007-10-23",
  "img_path": "/data/qiuhui/data/adni/images/024_S_0985/2007-10-23/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 42,407 mm³, 9.8% below the reference mean. With a Z-score of -0.28 (38.8th percentile), this represents normal volume ; hippocampal volume measures 5,609 mm³, 19.5% below the reference mean. With a Z-score of -1.69 (4.6th percentile), this represents moderate atrophy; whole brain volume measures 828,828 mm³, 19.5% below the reference mean. With a Z-score of -2.55 (0.5th percentile), this represents significant atrophy; entorhinal cortex volume measures 3,235 mm³, 18.5% below the reference mean. With a Z-score of -1.21 (11.3th percentile), this represents mild atrophy; fusiform gyrus volume measures 15,842 mm³, 12.3% below the reference mean. With a Z-score of -1.07 (14.3th percentile), this represents mild atrophy; middle temporal gyrus volume measures 14,694 mm³, 27.2% below the reference mean. With a Z-score of -2.43 (0.7th percentile), this represents significant atrophy. ",
  "text_data": "Age is 82.6 years. Gender is Male. Education: 14 years. MMSE: 30.0. Logical Memory: 2.0. APOEε4 alleles: 1.0. Biomarker levels: Pittsburgh compound B: 1.83 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the whole brain and middle temporal gyrus, moderate hippocampal atrophy, and mild atrophy in the entorhinal cortex and fusiform gyrus—all regions implicated in Alzheimer's disease. However, the MMSE score of 30 is normal, and ventricular volume is within the typical range, suggesting preserved cognitive function despite structural changes.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (due to significant structural atrophy but intact cognition)  \n**Confidence:** **Medium** (high confidence in atrophy patterns, but the discrepancy with MMSE raises questions about clinical progression or compensatory mechanisms).  \n\n*Note: Given the patient's age and APOE4 carrier status, close monitoring is recommended, as this profile suggests high risk for progression to dementia.*",
  "timestamp": "2025-07-26T03:11:51.251001"
}