{
  "ptid_time": "022_S_1097_2008-06-13",
  "img_path": "/data/qiuhui/data/adni/images/022_S_1097/2008-06-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 33,165 mm³, 13.9% below the reference mean. With a Z-score of -0.33 (37.0th percentile), this represents normal volume ; hippocampal volume measures 5,303 mm³, 29.8% below the reference mean. With a Z-score of -2.91 (0.2th percentile), this represents significant atrophy; whole brain volume measures 933,014 mm³, 13.6% below the reference mean. With a Z-score of -1.76 (3.9th percentile), this represents moderate atrophy; entorhinal cortex volume measures 3,578 mm³, 12.7% below the reference mean. With a Z-score of -0.86 (19.4th percentile), this represents normal volume ; fusiform gyrus volume measures 15,747 mm³, 16.4% below the reference mean. With a Z-score of -1.40 (8.1th percentile), this represents mild atrophy; middle temporal gyrus volume measures 17,808 mm³, 16.5% below the reference mean. With a Z-score of -1.49 (6.8th percentile), this represents mild atrophy. ",
  "text_data": "Age is 74.5 years. Gender is Male. Education: 18 years. MMSE: 26.0. Laboratory findings: . APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows significant atrophy (Z-score -2.91, 0.2th percentile), which is strongly associated with Alzheimer's disease. Whole brain and temporal lobe volumes also show moderate to mild atrophy, while ventricular and entorhinal cortex volumes are within normal limits. The MMSE score of 26 is borderline, suggesting mild cognitive impairment rather than severe dementia.  \n\n**Diagnosis:** **MCI (Mild Cognitive Impairment)**  \n**Confidence:** **Medium** (due to significant hippocampal atrophy but only borderline cognitive impairment and no APOE4 risk allele)",
  "timestamp": "2025-07-26T02:08:39.608634"
}