{
  "ptid_time": "024_S_4169_2012-10-24",
  "img_path": "/data/qiuhui/data/adni/images/024_S_4169/2012-10-24/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 19,785 mm³, 11.4% below the reference mean. With a Z-score of -0.29 (38.7th percentile), this represents normal volume ; hippocampal volume measures 7,148 mm³, 7.0% below the reference mean. With a Z-score of -0.78 (21.7th percentile), this represents normal volume ; whole brain volume measures 1,156,280 mm³, 12.4% above the reference mean. With a Z-score of 1.54 (93.8th percentile), this represents moderate enlargement; entorhinal cortex volume measures 2,938 mm³, 24.5% below the reference mean. With a Z-score of -1.90 (2.9th percentile), this represents moderate atrophy; fusiform gyrus volume measures 21,035 mm³, 15.5% above the reference mean. With a Z-score of 1.75 (96.0th percentile), this represents moderate enlargement; middle temporal gyrus volume measures 21,273 mm³, 3.7% above the reference mean. With a Z-score of 0.33 (62.8th percentile), this represents normal volume . ",
  "text_data": "Age is 63.0 years. Gender is Female. Education: 13 years. MMSE: 27.0. MoCA: 24.0. Logical Memory: 9.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows moderate atrophy (Z-score -1.90, 2.9th percentile), which is a strong early marker of Alzheimer’s pathology, while hippocampal volume is within normal limits. Cognitive scores (MMSE 27, MoCA 24) are borderline for MCI but not dementia. No APOE4 allele reduces genetic risk.  \n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Atrophy in a key AD-related region suggests early neurodegeneration, but cognitive scores are not severely impaired and APOE4-negative status tempers certainty.)",
  "timestamp": "2025-07-26T03:19:03.115157"
}