{
  "ptid_time": "068_S_2316_2011-10-03",
  "img_path": "/data/qiuhui/data/adni/images/068_S_2316/2011-10-03/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 30,001 mm³, 6.9% above the reference mean. With a Z-score of 0.16 (56.3th percentile), this represents normal volume ; hippocampal volume measures 6,493 mm³, 8.7% below the reference mean. With a Z-score of -0.80 (21.1th percentile), this represents normal volume ; whole brain volume measures 1,065,080 mm³, 9.3% above the reference mean. With a Z-score of 1.17 (87.9th percentile), this represents mild enlargement; entorhinal cortex volume measures 2,558 mm³, 30.4% below the reference mean. With a Z-score of -1.86 (3.1th percentile), this represents moderate atrophy; fusiform gyrus volume measures 17,755 mm³, 4.4% above the reference mean. With a Z-score of 0.40 (65.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,896 mm³, 11.9% below the reference mean. With a Z-score of -1.03 (15.2th percentile), this represents mild atrophy. ",
  "text_data": "Age is 74.8 years. Gender is Female. Education: 12 years. MMSE: 24.0. MoCA: 20.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows moderate atrophy in the entorhinal cortex (Z-score -1.86, 3.1th percentile) and mild atrophy in the middle temporal gyrus (Z-score -1.03, 15.2th percentile), both regions critical for memory and cognition. Combined with cognitive scores (MMSE 24, MoCA 20) below typical cutoffs for normal cognition, this suggests cognitive impairment. However, hippocampal volume is within normal limits (Z-score -0.80), which may argue against advanced neurodegeneration.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Cognitive scores and entorhinal atrophy support MCI, but preserved hippocampal volume introduces some uncertainty).",
  "timestamp": "2025-07-26T08:57:51.786094"
}