{
  "ptid_time": "099_S_0060_2007-01-11",
  "img_path": "/data/qiuhui/data/adni/images/099_S_0060/2007-01-11/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 30,137 mm³, 21.8% below the reference mean. With a Z-score of -0.52 (30.1th percentile), this represents normal volume ; hippocampal volume measures 7,161 mm³, 5.3% below the reference mean. With a Z-score of -0.51 (30.4th percentile), this represents normal volume ; whole brain volume measures 994,480 mm³, 7.9% below the reference mean. With a Z-score of -1.02 (15.4th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,830 mm³, 6.6% below the reference mean. With a Z-score of -0.45 (32.7th percentile), this represents normal volume ; fusiform gyrus volume measures 18,378 mm³, 2.4% below the reference mean. With a Z-score of -0.21 (41.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,412 mm³, 5.0% above the reference mean. With a Z-score of 0.45 (67.4th percentile), this represents normal volume . ",
  "text_data": "Age is 71.0 years. Gender is Male. Education: 20 years. MMSE: 26.0. Logical Memory: 2.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain imaging shows mild whole brain atrophy (Z-score -1.02, 15.4th percentile), but all other regional volumes (hippocampus, entorhinal cortex, fusiform gyrus, etc.) are within normal ranges. The MMSE score of 26 is slightly below the typical cutoff for normal cognition (≥27), but not low enough to suggest dementia. The presence of one APOE4 allele increases Alzheimer's risk but is not diagnostic.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to borderline MMSE and mild whole brain atrophy, but no significant hippocampal or other key regional atrophy)",
  "timestamp": "2025-07-26T10:52:26.885477"
}