{
  "ptid_time": "127_S_0622_2006-06-29",
  "img_path": "/data/qiuhui/data/adni/images/127_S_0622/2006-06-29/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 42,478 mm³, 51.3% above the reference mean. With a Z-score of 1.18 (88.0th percentile), this represents mild enlargement; hippocampal volume measures 5,198 mm³, 26.9% below the reference mean. With a Z-score of -2.47 (0.7th percentile), this represents significant atrophy; whole brain volume measures 849,916 mm³, 12.8% below the reference mean. With a Z-score of -1.61 (5.4th percentile), this represents moderate atrophy; entorhinal cortex volume measures 2,501 mm³, 31.9% below the reference mean. With a Z-score of -1.96 (2.5th percentile), this represents moderate atrophy; fusiform gyrus volume measures 13,375 mm³, 21.4% below the reference mean. With a Z-score of -1.95 (2.6th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 15,965 mm³, 16.7% below the reference mean. With a Z-score of -1.45 (7.3th percentile), this represents mild atrophy. ",
  "text_data": "Age is 74.5 years. Gender is Female. Education: 15 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Dermatologic-Connective Tissue; Musculoskeletal; Smoking. MMSE: 30.0. Logical Memory: 17.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant hippocampal atrophy (Z-score -2.47, 0.7th percentile) and moderate atrophy in the entorhinal cortex, fusiform gyrus, and whole brain, which are hallmark features of Alzheimer's pathology. However, the MMSE score of 30 is normal, suggesting no significant cognitive impairment at present.  \n\n**Diagnosis:** **MCI** (likely prodromal Alzheimer's, given structural changes despite intact cognition)  \n**Confidence:** **Medium** (high confidence in structural abnormalities, but clinical correlation is needed due to the discrepancy with MMSE)",
  "timestamp": "2025-07-26T13:01:23.165436"
}