{
  "ptid_time": "094_S_1417_2008-01-24",
  "img_path": "/data/qiuhui/data/adni/images/094_S_1417/2008-01-24/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 36,078 mm³, 20.2% above the reference mean. With a Z-score of 0.48 (68.4th percentile), this represents normal volume ; hippocampal volume measures 5,196 mm³, 35.3% below the reference mean. With a Z-score of -3.53 (0.0th percentile), this represents profound atrophy; whole brain volume measures 1,082,090 mm³, 4.6% below the reference mean. With a Z-score of -0.65 (25.6th percentile), this represents normal volume ; entorhinal cortex volume measures 2,151 mm³, 49.5% below the reference mean. With a Z-score of -3.43 (0.0th percentile), this represents profound atrophy; fusiform gyrus volume measures 16,308 mm³, 18.1% below the reference mean. With a Z-score of -1.50 (6.6th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 18,595 mm³, 17.0% below the reference mean. With a Z-score of -1.40 (8.0th percentile), this represents mild atrophy. ",
  "text_data": "Age is 63.6 years. Gender is Male. Education: 12 years. MMSE: 27.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound atrophy in the hippocampus and entorhinal cortex, which are key regions affected in Alzheimer's disease (AD), along with mild-to-moderate atrophy in the fusiform gyrus and middle temporal gyrus. Despite a normal MMSE score (27/30), the structural changes suggest early neurodegenerative pathology. The absence of APOE4 does not rule out AD, as sporadic cases are common.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to underlying Alzheimer's pathology given the hippocampal/entorhinal atrophy).  \n\n**Confidence:** **Medium** (clinical correlation with cognitive testing and biomarker data would strengthen certainty).",
  "timestamp": "2025-07-26T10:24:17.921070"
}