{
  "ptid_time": "137_S_0722_2009-09-17",
  "img_path": "/data/qiuhui/data/adni/images/137_S_0722/2009-09-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 56,200 mm³, 45.9% above the reference mean. With a Z-score of 1.10 (86.4th percentile), this represents mild enlargement; hippocampal volume measures 7,217 mm³, 4.5% below the reference mean. With a Z-score of -0.44 (32.9th percentile), this represents normal volume ; whole brain volume measures 1,168,300 mm³, 8.2% above the reference mean. With a Z-score of 1.07 (85.7th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,020 mm³, 26.4% below the reference mean. With a Z-score of -1.79 (3.7th percentile), this represents moderate atrophy; fusiform gyrus volume measures 16,886 mm³, 10.4% below the reference mean. With a Z-score of -0.88 (18.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 23,338 mm³, 9.4% above the reference mean. With a Z-score of 0.84 (80.0th percentile), this represents normal volume . ",
  "text_data": "Age is 73.1 years. Gender is Male. Education: 12 years. MMSE: 28.0. Logical Memory: 16.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows moderate atrophy (Z-score -1.79, 3.7th percentile), which is a strong early biomarker for Alzheimer's disease (AD). However, hippocampal volume is normal, MMSE is intact (28/30), and APOE4 is negative, suggesting no significant cognitive impairment at this stage.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (due to entorhinal atrophy but preserved global cognition)  \n**Confidence:** **Medium** (structural changes are concerning, but clinical cognitive performance remains normal)",
  "timestamp": "2025-07-26T16:16:29.079370"
}