{
  "ptid_time": "131_S_0384_2006-04-28",
  "img_path": "/data/qiuhui/data/adni/images/131_S_0384/2006-04-28/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 32,311 mm³, 16.1% below the reference mean. With a Z-score of -0.39 (35.0th percentile), this represents normal volume ; hippocampal volume measures 6,717 mm³, 11.1% below the reference mean. With a Z-score of -1.09 (13.9th percentile), this represents mild atrophy; whole brain volume measures 1,013,150 mm³, 6.1% below the reference mean. With a Z-score of -0.80 (21.3th percentile), this represents normal volume ; entorhinal cortex volume measures 4,106 mm³, 0.1% above the reference mean. With a Z-score of 0.01 (50.4th percentile), this represents normal volume ; fusiform gyrus volume measures 15,038 mm³, 20.2% below the reference mean. With a Z-score of -1.72 (4.3th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 18,590 mm³, 12.9% below the reference mean. With a Z-score of -1.16 (12.3th percentile), this represents mild atrophy. ",
  "text_data": "Age is 79.8 years. Gender is Male. Education: 14 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Major Surgical Procedures. MMSE: 29.0. Logical Memory: 6.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.09, 13.9th percentile), and the fusiform gyrus exhibits moderate atrophy (Z-score -1.72, 4.3th percentile), which are concerning for early neurodegenerative changes. However, the MMSE score of 29 is within the normal range, and other brain regions (ventricular, whole brain, entorhinal cortex) are normal. The absence of APOE4 alleles reduces genetic risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting findings—structural atrophy in key regions but preserved cognitive function on MMSE)",
  "timestamp": "2025-07-26T15:00:42.268189"
}