{
  "ptid_time": "033_S_1284_2007-02-12",
  "img_path": "/data/qiuhui/data/adni/images/033_S_1284/2007-02-12/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 69,541 mm³, 47.9% above the reference mean. With a Z-score of 1.39 (91.8th percentile), this represents mild enlargement; hippocampal volume measures 6,147 mm³, 11.8% below the reference mean. With a Z-score of -1.02 (15.4th percentile), this represents mild atrophy; whole brain volume measures 988,505 mm³, 4.0% below the reference mean. With a Z-score of -0.52 (30.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,900 mm³, 1.7% below the reference mean. With a Z-score of -0.11 (45.5th percentile), this represents normal volume ; fusiform gyrus volume measures 17,266 mm³, 4.4% below the reference mean. With a Z-score of -0.38 (35.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,112 mm³, 20.1% below the reference mean. With a Z-score of -1.80 (3.6th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 85.9 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking; Malignancy; Major Surgical Procedures. MMSE: 29.0. Logical Memory: 8.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows mild hippocampal atrophy (Z-score -1.02) and moderate middle temporal gyrus atrophy (Z-score -1.80), which are concerning for early neurodegenerative changes. However, MMSE is intact (29/30), and other regions (whole brain, entorhinal cortex, fusiform gyrus) are within normal limits. Ventricular enlargement suggests some age-related atrophy but is not severe.  \n**Diagnosis:** **MCI (Mild Cognitive Impairment)**  \n**Confidence:** **Medium** (Structural changes suggest early neurodegeneration, but preserved MMSE makes dementia less likely at this stage.)",
  "timestamp": "2025-07-26T05:32:50.739159"
}