{
  "ptid_time": "020_S_0883_2009-01-26",
  "img_path": "/data/qiuhui/data/adni/images/020_S_0883/2009-01-26/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 39,963 mm³, 42.4% above the reference mean. With a Z-score of 0.97 (83.4th percentile), this represents normal volume ; hippocampal volume measures 6,468 mm³, 9.1% below the reference mean. With a Z-score of -0.83 (20.2th percentile), this represents normal volume ; whole brain volume measures 963,955 mm³, 1.1% below the reference mean. With a Z-score of -0.14 (44.5th percentile), this represents normal volume ; entorhinal cortex volume measures 2,715 mm³, 26.1% below the reference mean. With a Z-score of -1.60 (5.5th percentile), this represents moderate atrophy; fusiform gyrus volume measures 17,882 mm³, 5.1% above the reference mean. With a Z-score of 0.46 (67.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,699 mm³, 7.7% below the reference mean. With a Z-score of -0.67 (25.3th percentile), this represents normal volume . ",
  "text_data": "Age is 78.1 years. Gender is Female. Education: 16 years. MMSE: 29.0. Logical Memory: 8.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows moderate atrophy (Z-score -1.60, 5.5th percentile), which is a key early marker of Alzheimer's pathology, while other brain volumes (hippocampus, whole brain, etc.) are within normal ranges. The MMSE score of 29 is intact, and the presence of one APOE4 allele increases Alzheimer's risk but does not confirm impairment.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (due to entorhinal atrophy in the context of preserved global cognition).  \n\n**Confidence:** **Medium** (structural changes suggest early neurodegeneration, but cognitive performance remains normal, making progression uncertain).",
  "timestamp": "2025-07-26T01:11:49.942337"
}