{
  "ptid_time": "021_S_0626_2008-08-27",
  "img_path": "/data/qiuhui/data/adni/images/021_S_0626/2008-08-27/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 33,665 mm³, 28.4% below the reference mean. With a Z-score of -0.82 (20.5th percentile), this represents normal volume ; hippocampal volume measures 5,486 mm³, 21.3% below the reference mean. With a Z-score of -1.84 (3.3th percentile), this represents moderate atrophy; whole brain volume measures 942,133 mm³, 8.5% below the reference mean. With a Z-score of -1.11 (13.4th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,932 mm³, 26.1% below the reference mean. With a Z-score of -1.71 (4.4th percentile), this represents moderate atrophy; fusiform gyrus volume measures 17,830 mm³, 1.3% below the reference mean. With a Z-score of -0.11 (45.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 15,910 mm³, 21.1% below the reference mean. With a Z-score of -1.89 (2.9th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 85.2 years. Gender is Male. Education: 16 years. MMSE: 23.0. Logical Memory: 5.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows moderate atrophy in the hippocampus, entorhinal cortex, and middle temporal gyrus—key regions affected in Alzheimer's disease. The MMSE score of 23 suggests mild cognitive impairment, and the absence of APOE4 does not rule out AD, especially given the structural findings.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given the atrophy pattern, but not yet meeting dementia criteria due to preserved function).  \n\n**Confidence:** **Medium** (clinical correlation needed to confirm functional impact; MMSE alone is insufficient for definitive staging).  \n\n*(Alternative consideration: Early dementia due to Alzheimer’s if functional decline is evident, but MCI is more conservative without that history.)*",
  "timestamp": "2025-07-26T01:32:27.898205"
}