{
  "ptid_time": "051_S_1040_2007-05-07",
  "img_path": "/data/qiuhui/data/adni/images/051_S_1040/2007-05-07/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 36,045 mm³, 6.4% below the reference mean. With a Z-score of -0.15 (43.9th percentile), this represents normal volume ; hippocampal volume measures 7,584 mm³, 0.3% above the reference mean. With a Z-score of 0.03 (51.3th percentile), this represents normal volume ; whole brain volume measures 1,097,260 mm³, 1.7% above the reference mean. With a Z-score of 0.21 (58.5th percentile), this represents normal volume ; entorhinal cortex volume measures 3,380 mm³, 17.6% below the reference mean. With a Z-score of -1.19 (11.7th percentile), this represents mild atrophy; fusiform gyrus volume measures 17,760 mm³, 5.7% below the reference mean. With a Z-score of -0.49 (31.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,697 mm³, 6.4% above the reference mean. With a Z-score of 0.57 (71.6th percentile), this represents normal volume . ",
  "text_data": "Age is 71.9 years. Gender is Male. Education: 11 years. MMSE: 27.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows mild atrophy (Z-score -1.19, 11.7th percentile), which is an early marker of Alzheimer's pathology, but other key regions (hippocampus, whole brain) are within normal ranges. The MMSE score of 27 is borderline but still within normal limits for age, and the absence of APOE4 reduces genetic risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Atrophy in the entorhinal cortex is concerning, but cognitive performance is not yet clearly impaired, and other biomarkers are normal.)",
  "timestamp": "2025-07-26T07:31:11.530129"
}