{
  "ptid_time": "941_S_1202_2007-01-30",
  "img_path": "/data/qiuhui/data/adni/images/941_S_1202/2007-01-30/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 54,143 mm³, 40.6% above the reference mean. With a Z-score of 0.97 (83.4th percentile), this represents normal volume ; hippocampal volume measures 5,743 mm³, 24.0% below the reference mean. With a Z-score of -2.34 (1.0th percentile), this represents significant atrophy; whole brain volume measures 1,052,020 mm³, 2.5% below the reference mean. With a Z-score of -0.33 (37.1th percentile), this represents normal volume ; entorhinal cortex volume measures 2,398 mm³, 41.5% below the reference mean. With a Z-score of -2.82 (0.2th percentile), this represents significant atrophy; fusiform gyrus volume measures 18,309 mm³, 2.8% below the reference mean. With a Z-score of -0.24 (40.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,014 mm³, 1.5% below the reference mean. With a Z-score of -0.14 (44.6th percentile), this represents normal volume . ",
  "text_data": "Age is 77.5 years. Gender is Male. Education: 18 years. Handedness: Right. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Smoking; Malignancy; Major Surgical Procedures. MMSE: 28.0. Logical Memory: 12.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant atrophy in the hippocampus and entorhinal cortex (both with Z-scores below -2.0), which are key regions affected in Alzheimer's disease. However, the MMSE score of 28 is within the normal range, and other brain volumes (ventricular, whole brain, fusiform gyrus, middle temporal gyrus) are normal. The absence of APOE4 also reduces genetic risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting biomarkers—structural atrophy suggests early neurodegeneration, but cognitive performance remains intact).",
  "timestamp": "2025-07-26T17:28:59.342262"
}