{
  "ptid_time": "013_S_2389_2012-10-10",
  "img_path": "/data/qiuhui/data/adni/images/013_S_2389/2012-10-10/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 20,038 mm³, 7.6% above the reference mean. With a Z-score of 0.22 (58.6th percentile), this represents normal volume ; whole brain volume measures 998,485 mm³, 4.0% below the reference mean. With a Z-score of -0.48 (31.4th percentile), this represents normal volume ; entorhinal cortex volume measures 2,834 mm³, 23.3% below the reference mean. With a Z-score of -1.82 (3.4th percentile), this represents moderate atrophy; fusiform gyrus volume measures 16,223 mm³, 12.0% below the reference mean. With a Z-score of -1.09 (13.8th percentile), this represents mild atrophy; middle temporal gyrus volume measures 20,118 mm³, 2.0% below the reference mean. With a Z-score of -0.17 (43.4th percentile), this represents normal volume . ",
  "text_data": "Age is 58.8 years. Gender is Female. Education: 15 years. Handedness: Right. Race: Unknown. Medical history: Malignancy; Major Surgical Procedures. MMSE: 28.0. MoCA: 20.0. Logical Memory: 6.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows moderate atrophy (Z-score -1.82, 3.4th percentile), which is a key early marker of Alzheimer’s pathology, while the fusiform gyrus shows mild atrophy. The MMSE is normal (28/30), but the MoCA (20/30) suggests cognitive impairment. The absence of APOE4 reduces genetic risk but does not rule out neurodegeneration.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to MoCA impairment and entorhinal atrophy, but normal MMSE and lack of APOE4 complicate full dementia diagnosis at this stage).",
  "timestamp": "2025-07-25T23:30:02.840399"
}