{
  "ptid_time": "007_S_0414_2007-06-13",
  "img_path": "/data/qiuhui/data/adni/images/007_S_0414/2007-06-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 35,969 mm³, 2.7% below the reference mean. With a Z-score of -0.07 (47.1th percentile), this represents normal volume ; hippocampal volume measures 4,538 mm³, 30.1% below the reference mean. With a Z-score of -2.41 (0.8th percentile), this represents significant atrophy; whole brain volume measures 877,551 mm³, 5.5% below the reference mean. With a Z-score of -0.65 (25.6th percentile), this represents normal volume ; entorhinal cortex volume measures 2,560 mm³, 26.1% below the reference mean. With a Z-score of -1.41 (8.0th percentile), this represents mild atrophy; fusiform gyrus volume measures 14,470 mm³, 10.2% below the reference mean. With a Z-score of -0.77 (22.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 15,041 mm³, 16.6% below the reference mean. With a Z-score of -1.47 (7.0th percentile), this represents mild atrophy. ",
  "text_data": "Age is 80.6 years. Gender is Female. Education: 18 years. MMSE: 26.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant hippocampal atrophy (Z-score -2.41, 0.8th percentile) and mild atrophy in the entorhinal cortex and middle temporal gyrus, which are key regions affected in Alzheimer's disease. The MMSE score of 26 is borderline, but the structural changes suggest cognitive impairment.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer's disease given hippocampal atrophy and APOE4 carrier status).  \n\n**Confidence:** **Medium** (clinical correlation with neuropsychological testing would strengthen confidence).",
  "timestamp": "2025-07-25T21:50:35.635700"
}