{
  "ptid_time": "037_S_0566_2008-02-12",
  "img_path": "/data/qiuhui/data/adni/images/037_S_0566/2008-02-12/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 33,522 mm³, 28.7% below the reference mean. With a Z-score of -0.83 (20.2th percentile), this represents normal volume ; hippocampal volume measures 4,192 mm³, 39.8% below the reference mean. With a Z-score of -3.44 (0.0th percentile), this represents profound atrophy; whole brain volume measures 885,425 mm³, 14.0% below the reference mean. With a Z-score of -1.83 (3.4th percentile), this represents moderate atrophy; entorhinal cortex volume measures 2,001 mm³, 49.6% below the reference mean. With a Z-score of -3.25 (0.1th percentile), this represents profound atrophy; fusiform gyrus volume measures 14,234 mm³, 21.2% below the reference mean. With a Z-score of -1.84 (3.3th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 18,387 mm³, 8.8% below the reference mean. With a Z-score of -0.79 (21.4th percentile), this represents normal volume . ",
  "text_data": "Age is 80.3 years. Gender is Male. Education: 20 years. MMSE: 29.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows profound atrophy in the hippocampus and entorhinal cortex, which are key regions affected in Alzheimer's disease, along with moderate whole brain and fusiform gyrus atrophy. Despite the high MMSE score (29/30), the structural changes suggest significant neurodegeneration, likely in the early stages of dementia given the preserved cognitive performance.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given hippocampal/entorhinal atrophy and APOE4 positivity).  \n\n**Confidence:** **Medium** (high confidence in neurodegeneration, but MCI diagnosis is provisional due to the discrepancy between imaging and MMSE; clinical follow-up or additional biomarkers would strengthen certainty).",
  "timestamp": "2025-07-26T06:33:11.920433"
}