{
  "ptid_time": "094_S_1293_2008-09-18",
  "img_path": "/data/qiuhui/data/adni/images/094_S_1293/2008-09-18/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 47,097 mm³, 22.3% above the reference mean. With a Z-score of 0.53 (70.3th percentile), this represents normal volume ; hippocampal volume measures 5,554 mm³, 26.5% below the reference mean. With a Z-score of -2.59 (0.5th percentile), this represents significant atrophy; whole brain volume measures 1,102,870 mm³, 2.2% above the reference mean. With a Z-score of 0.28 (61.1th percentile), this represents normal volume ; entorhinal cortex volume measures 2,778 mm³, 32.3% below the reference mean. With a Z-score of -2.19 (1.4th percentile), this represents significant atrophy; fusiform gyrus volume measures 14,825 mm³, 21.3% below the reference mean. With a Z-score of -1.81 (3.5th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 22,671 mm³, 6.2% above the reference mean. With a Z-score of 0.56 (71.3th percentile), this represents normal volume . ",
  "text_data": "Age is 78.6 years. Gender is Male. Education: 16 years. MMSE: 26.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant atrophy in the hippocampus and entorhinal cortex, both critical regions for memory and early Alzheimer's pathology, along with moderate atrophy in the fusiform gyrus. The MMSE score of 26 is borderline, and the presence of two APOE4 alleles increases Alzheimer's risk. However, other brain regions remain normal, suggesting early-stage neurodegeneration rather than widespread dementia.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (While hippocampal/entorhinal atrophy strongly suggests MCI, the MMSE is near-normal, and cognitive symptoms would need further clinical correlation.)",
  "timestamp": "2025-07-26T10:21:51.784063"
}