{
  "ptid_time": "011_S_4235_2012-04-12",
  "img_path": "/data/qiuhui/data/adni/images/011_S_4235/2012-04-12/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 32,268 mm³, 7.5% above the reference mean. With a Z-score of 0.18 (57.0th percentile), this represents normal volume ; hippocampal volume measures 6,412 mm³, 20.1% below the reference mean. With a Z-score of -2.01 (2.2th percentile), this represents significant atrophy; whole brain volume measures 1,192,750 mm³, 5.1% above the reference mean. With a Z-score of 0.73 (76.6th percentile), this represents normal volume ; entorhinal cortex volume measures 2,942 mm³, 31.0% below the reference mean. With a Z-score of -2.14 (1.6th percentile), this represents significant atrophy; fusiform gyrus volume measures 23,134 mm³, 16.2% above the reference mean. With a Z-score of 1.35 (91.1th percentile), this represents mild enlargement; middle temporal gyrus volume measures 22,606 mm³, 0.9% above the reference mean. With a Z-score of 0.07 (52.8th percentile), this represents normal volume . ",
  "text_data": "Age is 64.3 years. Gender is Male. Education: 16 years. MMSE: 28.0. MoCA: 24.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant atrophy in the hippocampus (-2.01 Z-score) and entorhinal cortex (-2.14 Z-score), both key regions affected in Alzheimer's disease. Despite normal MMSE (28) and borderline MoCA (24), the structural changes suggest early neurodegeneration.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to preserved cognitive scores but strong biomarker evidence of atrophy)",
  "timestamp": "2025-07-25T22:56:11.487716"
}