{
  "ptid_time": "068_S_0442_2007-06-26",
  "img_path": "/data/qiuhui/data/adni/images/068_S_0442/2007-06-26/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 51,955 mm³, 34.9% above the reference mean. With a Z-score of 0.84 (79.8th percentile), this represents normal volume ; hippocampal volume measures 4,704 mm³, 37.8% below the reference mean. With a Z-score of -3.68 (0.0th percentile), this represents profound atrophy; whole brain volume measures 1,035,310 mm³, 4.1% below the reference mean. With a Z-score of -0.53 (29.8th percentile), this represents normal volume ; entorhinal cortex volume measures 2,321 mm³, 43.4% below the reference mean. With a Z-score of -2.94 (0.2th percentile), this represents significant atrophy; fusiform gyrus volume measures 14,526 mm³, 22.9% below the reference mean. With a Z-score of -1.95 (2.6th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 18,803 mm³, 11.9% below the reference mean. With a Z-score of -1.07 (14.3th percentile), this represents mild atrophy. ",
  "text_data": "Age is 75.7 years. Gender is Male. Education: 16 years. MMSE: 27.0. Logical Memory: 1.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows profound hippocampal atrophy (Z-score -3.68) and significant entorhinal cortex atrophy (Z-score -2.94), both strongly associated with Alzheimer's pathology. Despite a normal MMSE (27/30), these structural changes, along with APOE4 positivity, suggest early neurodegeneration.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer’s disease)  \n**Confidence:** **High** (due to severe medial temporal lobe atrophy in a high-risk profile)  \n\n*Note: The MMSE is insensitive to early MCI, and the structural findings outweigh the cognitive screening result. Progression to dementia is likely if underlying AD pathology is present.*",
  "timestamp": "2025-07-26T08:48:10.748082"
}