{
  "ptid_time": "137_S_0481_2007-12-05",
  "img_path": "/data/qiuhui/data/adni/images/137_S_0481/2007-12-05/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 51,519 mm³, 9.6% above the reference mean. With a Z-score of 0.28 (61.0th percentile), this represents normal volume ; hippocampal volume measures 5,955 mm³, 14.5% below the reference mean. With a Z-score of -1.26 (10.5th percentile), this represents mild atrophy; whole brain volume measures 978,899 mm³, 4.9% below the reference mean. With a Z-score of -0.64 (26.1th percentile), this represents normal volume ; entorhinal cortex volume measures 3,383 mm³, 14.8% below the reference mean. With a Z-score of -0.97 (16.7th percentile), this represents normal volume ; fusiform gyrus volume measures 17,171 mm³, 5.0% below the reference mean. With a Z-score of -0.43 (33.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,478 mm³, 13.4% below the reference mean. With a Z-score of -1.20 (11.6th percentile), this represents mild atrophy. ",
  "text_data": "Age is 86.3 years. Gender is Male. Education: 18 years. MMSE: 26.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal and middle temporal gyrus volumes show mild atrophy (Z-scores of -1.26 and -1.20, respectively), which are early markers of Alzheimer's pathology. The MMSE score of 26 is borderline but still within the normal range for age, suggesting possible mild cognitive impairment (MCI) rather than dementia. The presence of one APOE4 allele increases Alzheimer's risk but does not confirm the diagnosis alone.  \n\n**Diagnosis:** **MCI** (Mild Cognitive Impairment)  \n**Confidence:** **Medium** (due to borderline MMSE and mild atrophy in key regions, but no clear functional decline to meet dementia criteria)",
  "timestamp": "2025-07-26T16:11:51.985740"
}