{
  "ptid_time": "128_S_0258_2006-10-20",
  "img_path": "/data/qiuhui/data/adni/images/128_S_0258/2006-10-20/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 52,084 mm³, 85.6% above the reference mean. With a Z-score of 1.96 (97.5th percentile), this represents moderate enlargement; hippocampal volume measures 5,938 mm³, 16.5% below the reference mean. With a Z-score of -1.52 (6.5th percentile), this represents moderate atrophy; whole brain volume measures 1,059,990 mm³, 8.8% above the reference mean. With a Z-score of 1.10 (86.5th percentile), this represents mild enlargement; entorhinal cortex volume measures 2,416 mm³, 34.2% below the reference mean. With a Z-score of -2.10 (1.8th percentile), this represents significant atrophy; fusiform gyrus volume measures 15,209 mm³, 10.6% below the reference mean. With a Z-score of -0.97 (16.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,883 mm³, 3.7% above the reference mean. With a Z-score of 0.32 (62.7th percentile), this represents normal volume . ",
  "text_data": "Age is 71.8 years. Gender is Female. Education: 14 years. MMSE: 27.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant atrophy in the entorhinal cortex (Z-score -2.10, 1.8th percentile) and moderate atrophy in the hippocampus (Z-score -1.52, 6.5th percentile), both key regions affected in Alzheimer's disease. Despite a normal MMSE score (27/30), the structural changes suggest neurodegeneration. The presence of one APOE4 allele further increases Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer's given biomarker profile)  \n**Confidence:** **Medium** (MMSE is borderline normal, but imaging strongly suggests early pathology)",
  "timestamp": "2025-07-26T13:42:42.766518"
}