{
  "ptid_time": "135_S_4489_2016-02-22",
  "img_path": "/data/qiuhui/data/adni/images/135_S_4489/2016-02-22/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 31,140 mm³, 19.2% below the reference mean. With a Z-score of -0.46 (32.3th percentile), this represents normal volume ; hippocampal volume measures 7,532 mm³, 0.4% below the reference mean. With a Z-score of -0.04 (48.6th percentile), this represents normal volume ; whole brain volume measures 1,075,730 mm³, 0.3% below the reference mean. With a Z-score of -0.04 (48.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,278 mm³, 20.1% below the reference mean. With a Z-score of -1.36 (8.7th percentile), this represents mild atrophy; fusiform gyrus volume measures 19,471 mm³, 3.4% above the reference mean. With a Z-score of 0.29 (61.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,865 mm³, 7.2% above the reference mean. With a Z-score of 0.64 (74.0th percentile), this represents normal volume . ",
  "text_data": "Age is 78.2 years. Gender is Male. Education: 20 years. MMSE: 30.0. MoCA: 28.0. Logical Memory: 11.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.24 SUVR (mild elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "Reasoning: The entorhinal cortex shows mild atrophy (Z-score -1.36, 8.7th percentile), which is a potential early marker of Alzheimer's pathology. However, hippocampal and whole brain volumes are normal, and cognitive scores (MMSE 30, MoCA 28) are intact. No APOE4 risk allele and only mild amyloid elevation (AV45) further reduce concern for significant neurodegeneration.  \nDiagnosis: CN (Cognitively Normal)  \nConfidence: Medium (due to isolated entorhinal atrophy but otherwise normal findings)",
  "timestamp": "2025-07-26T15:37:22.863117"
}