{
  "ptid_time": "016_S_1117_2007-12-18",
  "img_path": "/data/qiuhui/data/adni/images/016_S_1117/2007-12-18/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 16,080 mm³, 28.0% below the reference mean. With a Z-score of -0.70 (24.2th percentile), this represents normal volume ; hippocampal volume measures 6,729 mm³, 12.4% below the reference mean. With a Z-score of -1.40 (8.1th percentile), this represents mild atrophy; whole brain volume measures 924,196 mm³, 10.2% below the reference mean. With a Z-score of -1.27 (10.2th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,925 mm³, 24.9% below the reference mean. With a Z-score of -1.93 (2.7th percentile), this represents moderate atrophy; fusiform gyrus volume measures 13,180 mm³, 27.6% below the reference mean. With a Z-score of -3.11 (0.1th percentile), this represents profound atrophy; middle temporal gyrus volume measures 18,372 mm³, 10.5% below the reference mean. With a Z-score of -0.93 (17.6th percentile), this represents normal volume . ",
  "text_data": "Age is 69.9 years. Gender is Female. Education: 18 years. MMSE: 25.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows mild to profound atrophy in key Alzheimer's-related regions (hippocampus, entorhinal cortex, fusiform gyrus), while ventricular volume and middle temporal gyrus are normal. The MMSE score of 25 is borderline, but the structural changes, particularly in the fusiform gyrus (Z-score -3.11), strongly suggest neurodegeneration. The absence of APOE4 does not rule out Alzheimer's, as atrophy patterns are highly suggestive.  \n\n**Diagnosis:** Dementia (likely Alzheimer’s disease)  \n**Confidence:** Medium (due to borderline MMSE and lack of APOE4, but imaging strongly supports neurodegeneration)",
  "timestamp": "2025-07-26T00:13:06.257993"
}