{
  "ptid_time": "037_S_0150_2009-04-22",
  "img_path": "/data/qiuhui/data/adni/images/037_S_0150/2009-04-22/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 57,901 mm³, 50.3% above the reference mean. With a Z-score of 1.21 (88.6th percentile), this represents mild enlargement; hippocampal volume measures 5,461 mm³, 27.8% below the reference mean. With a Z-score of -2.71 (0.3th percentile), this represents significant atrophy; whole brain volume measures 1,049,540 mm³, 2.8% below the reference mean. With a Z-score of -0.36 (36.0th percentile), this represents normal volume ; entorhinal cortex volume measures 3,324 mm³, 18.9% below the reference mean. With a Z-score of -1.28 (10.0th percentile), this represents mild atrophy; fusiform gyrus volume measures 19,467 mm³, 3.3% above the reference mean. With a Z-score of 0.28 (61.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,912 mm³, 6.7% below the reference mean. With a Z-score of -0.60 (27.4th percentile), this represents normal volume . ",
  "text_data": "Age is 76.9 years. Gender is Male. Education: 12 years. MMSE: 27.0. Logical Memory: 3.0. APOEε4 alleles: 0.0. Biomarker levels: Pittsburgh compound B: 2.25 SUVR (moderate elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant hippocampal atrophy (Z-score -2.71, 0.3rd percentile) and mild entorhinal cortex atrophy, both key regions in Alzheimer's pathology. Despite a normal MMSE (27/30), the structural changes suggest neurodegeneration, though the absence of APOE4 and preserved whole-brain volume may indicate a slower progression.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (High hippocampal atrophy supports MCI, but MMSE is near-normal and APOE4-negative, leaving room for non-AD etiologies or early-stage dementia).  \n\n*Note: Follow-up with CSF biomarkers (e.g., Aβ42, p-tau) or amyloid PET would strengthen diagnostic certainty.*",
  "timestamp": "2025-07-26T06:24:14.662363"
}