{
  "ptid_time": "011_S_4893_2013-04-04",
  "img_path": "/data/qiuhui/data/adni/images/011_S_4893/2013-04-04/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 16,210 mm³, 27.4% below the reference mean. With a Z-score of -0.69 (24.6th percentile), this represents normal volume ; hippocampal volume measures 6,969 mm³, 9.3% below the reference mean. With a Z-score of -1.04 (14.8th percentile), this represents mild atrophy; whole brain volume measures 951,296 mm³, 7.6% below the reference mean. With a Z-score of -0.94 (17.3th percentile), this represents normal volume ; entorhinal cortex volume measures 2,742 mm³, 29.6% below the reference mean. With a Z-score of -2.29 (1.1th percentile), this represents significant atrophy; fusiform gyrus volume measures 17,921 mm³, 1.6% below the reference mean. With a Z-score of -0.18 (42.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,931 mm³, 7.7% below the reference mean. With a Z-score of -0.69 (24.6th percentile), this represents normal volume . ",
  "text_data": "Age is 68.6 years. Gender is Female. Education: 12 years. MMSE: 27.0. MoCA: 24.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant atrophy in the entorhinal cortex (Z-score -2.29, 1.1th percentile) and mild hippocampal atrophy (Z-score -1.04, 14.8th percentile), both key regions in Alzheimer's pathology. Cognitive scores (MMSE 27, MoCA 24) are borderline, with MoCA slightly below the typical cutoff for normal cognition (26). APOE4 carrier status increases Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Structural changes suggest early neurodegeneration, but cognitive scores are not yet in the dementia range.)",
  "timestamp": "2025-07-25T23:00:40.822847"
}