{
  "ptid_time": "098_S_4215_2012-03-21",
  "img_path": "/data/qiuhui/data/adni/images/098_S_4215/2012-03-21/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 54,676 mm³, 16.3% above the reference mean. With a Z-score of 0.47 (68.2th percentile), this represents normal volume ; hippocampal volume measures 6,423 mm³, 7.8% below the reference mean. With a Z-score of -0.68 (25.0th percentile), this represents normal volume ; whole brain volume measures 1,072,790 mm³, 4.2% above the reference mean. With a Z-score of 0.56 (71.1th percentile), this represents normal volume ; entorhinal cortex volume measures 2,947 mm³, 25.7% below the reference mean. With a Z-score of -1.69 (4.6th percentile), this represents moderate atrophy; fusiform gyrus volume measures 16,983 mm³, 6.0% below the reference mean. With a Z-score of -0.52 (30.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,902 mm³, 6.3% below the reference mean. With a Z-score of -0.56 (28.6th percentile), this represents normal volume . ",
  "text_data": "Age is 82.1 years. Gender is Male. Education: 20 years. MMSE: 25.0. MoCA: 22.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows moderate atrophy (Z-score -1.69, 4.6th percentile), which is a key early marker of Alzheimer’s pathology. Other brain volumes (hippocampus, whole brain, fusiform gyrus, middle temporal gyrus) are within normal ranges. Cognitive scores (MMSE 25, MoCA 22) suggest mild cognitive impairment (MCI) rather than dementia.  \n\n**Diagnosis:** **MCI** (likely due to Alzheimer’s pathology given entorhinal atrophy and APOE4 carrier status).  \n**Confidence:** **Medium** (cognitive scores are borderline, and while entorhinal atrophy is concerning, other regions are preserved).",
  "timestamp": "2025-07-26T10:48:11.794822"
}