{
  "ptid_time": "023_S_1104_2006-12-05",
  "img_path": "/data/qiuhui/data/adni/images/023_S_1104/2006-12-05/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 11,110 mm³, 50.3% below the reference mean. With a Z-score of -1.26 (10.4th percentile), this represents mild atrophy; hippocampal volume measures 6,666 mm³, 13.3% below the reference mean. With a Z-score of -1.49 (6.8th percentile), this represents mild atrophy; whole brain volume measures 938,277 mm³, 8.8% below the reference mean. With a Z-score of -1.10 (13.6th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,973 mm³, 2.1% above the reference mean. With a Z-score of 0.16 (56.3th percentile), this represents normal volume ; fusiform gyrus volume measures 18,928 mm³, 3.9% above the reference mean. With a Z-score of 0.44 (67.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,496 mm³, 19.6% below the reference mean. With a Z-score of -1.74 (4.1th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 64.5 years. Gender is Female. Education: 12 years. Handedness: Right. Race: American Indian or Alaskan Native. Medical history: Cardiovascular; Musculoskeletal; Hematopoietic-Lymphatic; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 25.0. Logical Memory: 4.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient exhibits mild to moderate atrophy in key regions associated with Alzheimer's disease (AD), including the hippocampus and middle temporal gyrus, alongside mild whole-brain and ventricular volume changes. The MMSE score of 25 suggests mild cognitive impairment, and the presence of two APOE4 alleles increases AD risk. However, preserved entorhinal cortex and fusiform gyrus volumes argue against advanced neurodegeneration.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely amnestic subtype, given hippocampal involvement).  \n\n**Confidence:** **Medium** (structural changes and genetic risk support MCI, but clinical correlation with neuropsychological testing would strengthen certainty).",
  "timestamp": "2025-07-26T02:54:01.815890"
}