{
  "ptid_time": "136_S_0194_2007-04-02",
  "img_path": "/data/qiuhui/data/adni/images/136_S_0194/2007-04-02/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 23,266 mm³, 37.1% below the reference mean. With a Z-score of -1.00 (15.9th percentile), this represents mild atrophy; hippocampal volume measures 5,328 mm³, 18.0% below the reference mean. With a Z-score of -1.44 (7.5th percentile), this represents mild atrophy; whole brain volume measures 826,244 mm³, 11.0% below the reference mean. With a Z-score of -1.32 (9.4th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,884 mm³, 16.7% below the reference mean. With a Z-score of -0.90 (18.3th percentile), this represents normal volume ; fusiform gyrus volume measures 14,687 mm³, 8.8% below the reference mean. With a Z-score of -0.66 (25.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 13,515 mm³, 25.0% below the reference mean. With a Z-score of -2.23 (1.3th percentile), this represents significant atrophy. ",
  "text_data": "Age is 81.5 years. Gender is Female. Education: 12 years. MMSE: 25.0. Logical Memory: 2.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows mild to moderate atrophy in multiple brain regions, including the hippocampus and middle temporal gyrus (significant atrophy, Z-score -2.23). The MMSE score of 25 is borderline, suggesting possible cognitive impairment, but not severe enough for dementia. The absence of APOE4 reduces but does not eliminate Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to mixed imaging findings and borderline MMSE, but hippocampal/middle temporal atrophy supports MCI over normal aging)",
  "timestamp": "2025-07-26T15:58:47.643177"
}