{
  "ptid_time": "041_S_0282_2007-05-08",
  "img_path": "/data/qiuhui/data/adni/images/041_S_0282/2007-05-08/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 17,613 mm³, 54.3% below the reference mean. With a Z-score of -1.30 (9.7th percentile), this represents mild atrophy; hippocampal volume measures 7,794 mm³, 3.1% above the reference mean. With a Z-score of 0.30 (61.9th percentile), this represents normal volume ; whole brain volume measures 887,883 mm³, 17.7% below the reference mean. With a Z-score of -2.30 (1.1th percentile), this represents significant atrophy; entorhinal cortex volume measures 4,308 mm³, 5.1% above the reference mean. With a Z-score of 0.34 (63.4th percentile), this represents normal volume ; fusiform gyrus volume measures 16,534 mm³, 12.2% below the reference mean. With a Z-score of -1.04 (14.9th percentile), this represents mild atrophy; middle temporal gyrus volume measures 16,226 mm³, 24.0% below the reference mean. With a Z-score of -2.15 (1.6th percentile), this represents significant atrophy. ",
  "text_data": "Age is 73.1 years. Gender is Male. Education: 20 years. MMSE: 28.0. Logical Memory: 7.0. APOEε4 alleles: 0.0. Biomarker levels: Pittsburgh compound B: 1.25 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant whole-brain atrophy (Z-score -2.30) and middle temporal gyrus atrophy (Z-score -2.15), which are concerning for neurodegenerative changes. However, hippocampal and entorhinal cortex volumes are normal, and MMSE is intact (28/30), suggesting preserved cognitive function despite structural changes.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (structural atrophy without significant cognitive decline)  \n**Confidence:** **Medium** (atrophy patterns suggest early neurodegeneration, but cognitive performance remains high; APOE4-negative status reduces Alzheimer’s risk but does not rule out other causes of MCI).",
  "timestamp": "2025-07-26T06:57:07.119410"
}