{
  "ptid_time": "031_S_0351_2006-04-18",
  "img_path": "/data/qiuhui/data/adni/images/031_S_0351/2006-04-18/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 32,882 mm³, 9.5% above the reference mean. With a Z-score of 0.23 (58.9th percentile), this represents normal volume ; hippocampal volume measures 6,266 mm³, 21.9% below the reference mean. With a Z-score of -2.19 (1.4th percentile), this represents significant atrophy; whole brain volume measures 1,152,320 mm³, 1.6% above the reference mean. With a Z-score of 0.22 (58.8th percentile), this represents normal volume ; entorhinal cortex volume measures 2,411 mm³, 43.4% below the reference mean. With a Z-score of -3.01 (0.1th percentile), this represents profound atrophy; fusiform gyrus volume measures 19,216 mm³, 3.5% below the reference mean. With a Z-score of -0.29 (38.6th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,739 mm³, 16.4% below the reference mean. With a Z-score of -1.35 (8.9th percentile), this represents mild atrophy. ",
  "text_data": "Age is 68.4 years. Gender is Male. Education: 18 years. Handedness: Left. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Dermatologic-Connective Tissue; Gastrointestinal; Smoking; Malignancy; Major Surgical Procedures. MMSE: 29.0. Logical Memory: 2.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal and entorhinal cortex volumes show significant atrophy (Z-scores of -2.19 and -3.01, respectively), which are strongly associated with Alzheimer's pathology. However, the MMSE score of 29 is within the normal range, and whole brain volume is normal. The absence of APOE4 reduces genetic risk but does not rule out neurodegeneration.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (given structural atrophy in memory-related regions despite intact global cognition).  \n\n**Confidence:** **Medium** (due to the discrepancy between structural atrophy and preserved MMSE, suggesting early-stage changes).",
  "timestamp": "2025-07-26T04:35:21.653640"
}