{
  "ptid_time": "128_S_4636_2013-04-17",
  "img_path": "/data/qiuhui/data/adni/images/128_S_4636/2013-04-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 23,160 mm³, 17.5% below the reference mean. With a Z-score of -0.40 (34.4th percentile), this represents normal volume ; hippocampal volume measures 6,147 mm³, 13.6% below the reference mean. With a Z-score of -1.25 (10.6th percentile), this represents mild atrophy; whole brain volume measures 929,662 mm³, 4.6% below the reference mean. With a Z-score of -0.58 (28.1th percentile), this represents normal volume ; entorhinal cortex volume measures 2,027 mm³, 44.8% below the reference mean. With a Z-score of -2.75 (0.3th percentile), this represents significant atrophy; fusiform gyrus volume measures 16,078 mm³, 5.5% below the reference mean. With a Z-score of -0.50 (30.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 14,405 mm³, 24.9% below the reference mean. With a Z-score of -2.16 (1.5th percentile), this represents significant atrophy. ",
  "text_data": "Age is 78.1 years. Gender is Female. Education: 16 years. MMSE: 25.0. MoCA: 25.0. Logical Memory: 3.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the entorhinal cortex (Z-score -2.75) and middle temporal gyrus (Z-score -2.16), both key regions in Alzheimer's pathology, along with mild hippocampal atrophy (Z-score -1.25). Cognitive scores (MMSE 25, MoCA 25) are borderline but not severely impaired, suggesting early cognitive decline rather than frank dementia.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Cognitive scores are near-normal, but structural atrophy in AD-vulnerable regions raises concern for prodromal AD. APOE4 carrier status supports risk but isn't definitive.)",
  "timestamp": "2025-07-26T14:03:58.167963"
}