{
  "ptid_time": "037_S_0303_2006-04-07",
  "img_path": "/data/qiuhui/data/adni/images/037_S_0303/2006-04-07/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 33,209 mm³, 29.4% below the reference mean. With a Z-score of -0.85 (19.7th percentile), this represents normal volume ; hippocampal volume measures 5,998 mm³, 13.9% below the reference mean. With a Z-score of -1.20 (11.4th percentile), this represents mild atrophy; whole brain volume measures 937,578 mm³, 8.9% below the reference mean. With a Z-score of -1.17 (12.2th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,373 mm³, 15.0% below the reference mean. With a Z-score of -0.98 (16.3th percentile), this represents normal volume ; fusiform gyrus volume measures 17,172 mm³, 4.9% below the reference mean. With a Z-score of -0.43 (33.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,748 mm³, 12.0% below the reference mean. With a Z-score of -1.08 (14.1th percentile), this represents mild atrophy. ",
  "text_data": "Age is 84.2 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Hematopoietic-Lymphatic; Renal-Genitourinary; Major Surgical Procedures. MMSE: 29.0. Logical Memory: 12.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal and whole brain volumes show mild atrophy (Z-scores -1.20 and -1.17, respectively), while other regions are within normal ranges. The MMSE score of 29 is intact, suggesting no significant cognitive impairment. Given the mild atrophy but preserved cognition, this aligns with early neurodegenerative changes but not yet meeting dementia criteria.  \n\n**Diagnosis:** **MCI (Mild Cognitive Impairment)**  \n**Confidence:** **Medium** (due to borderline atrophy and high MMSE, but age and APOE4 status increase risk of progression)",
  "timestamp": "2025-07-26T06:25:06.452221"
}