{
  "ptid_time": "123_S_0162_2007-05-02",
  "img_path": "/data/qiuhui/data/adni/images/123_S_0162/2007-05-02/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 37,935 mm³, 1.5% below the reference mean. With a Z-score of -0.04 (48.6th percentile), this represents normal volume ; hippocampal volume measures 6,937 mm³, 8.2% below the reference mean. With a Z-score of -0.80 (21.1th percentile), this represents normal volume ; whole brain volume measures 1,119,500 mm³, 3.7% above the reference mean. With a Z-score of 0.48 (68.5th percentile), this represents normal volume ; entorhinal cortex volume measures 3,313 mm³, 19.2% below the reference mean. With a Z-score of -1.30 (9.6th percentile), this represents mild atrophy; fusiform gyrus volume measures 16,725 mm³, 11.2% below the reference mean. With a Z-score of -0.96 (17.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 23,961 mm³, 12.3% above the reference mean. With a Z-score of 1.10 (86.5th percentile), this represents mild enlargement. ",
  "text_data": "Age is 72.8 years. Gender is Male. Education: 18 years. MMSE: 27.0. Logical Memory: 2.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows mild atrophy (Z-score -1.30, 9.6th percentile), which is concerning for early neurodegenerative changes, while hippocampal volume is within normal limits (Z-score -0.80). The MMSE score of 27 is borderline but still within normal range. APOE4 carrier status increases Alzheimer's risk, but structural changes are not yet severe.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Atrophy in the entorhinal cortex is a red flag, but other regions are largely normal, and cognitive performance is only mildly affected.)",
  "timestamp": "2025-07-26T12:26:42.546451"
}