{
  "ptid_time": "053_S_0389_2009-05-27",
  "img_path": "/data/qiuhui/data/adni/images/053_S_0389/2009-05-27/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 45,958 mm³, 63.7% above the reference mean. With a Z-score of 1.46 (92.8th percentile), this represents mild enlargement; hippocampal volume measures 4,377 mm³, 38.5% below the reference mean. With a Z-score of -3.53 (0.0th percentile), this represents profound atrophy; whole brain volume measures 1,000,180 mm³, 2.6% above the reference mean. With a Z-score of 0.33 (62.9th percentile), this represents normal volume ; entorhinal cortex volume measures 2,371 mm³, 35.4% below the reference mean. With a Z-score of -2.18 (1.5th percentile), this represents significant atrophy; fusiform gyrus volume measures 17,524 mm³, 3.0% above the reference mean. With a Z-score of 0.27 (60.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,854 mm³, 12.1% below the reference mean. With a Z-score of -1.05 (14.7th percentile), this represents mild atrophy. ",
  "text_data": "Age is 74.5 years. Gender is Female. Education: 16 years. MMSE: 26.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound hippocampal atrophy (Z-score -3.53) and significant entorhinal cortex atrophy (Z-score -2.18), both strongly associated with Alzheimer's pathology. Mild ventricular enlargement and a slightly below-average MMSE score (26/30) further support cognitive decline, though not yet severe.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given APOE4 positivity and medial temporal atrophy).  \n\n**Confidence:** **High** (structural atrophy patterns are highly suggestive, and MMSE aligns with MCI).  \n\n*(Note: Progression to dementia is likely if hippocampal/entorhinal atrophy worsens, but current MMSE does not meet dementia thresholds.)*",
  "timestamp": "2025-07-26T07:53:51.867363"
}