{
  "ptid_time": "073_S_4382_2012-05-17",
  "img_path": "/data/qiuhui/data/adni/images/073_S_4382/2012-05-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 19,123 mm³, 31.9% below the reference mean. With a Z-score of -0.73 (23.3th percentile), this represents normal volume ; whole brain volume measures 879,704 mm³, 9.7% below the reference mean. With a Z-score of -1.23 (11.0th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,404 mm³, 34.5% below the reference mean. With a Z-score of -2.12 (1.7th percentile), this represents significant atrophy; fusiform gyrus volume measures 14,026 mm³, 17.6% below the reference mean. With a Z-score of -1.60 (5.5th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 16,961 mm³, 11.5% below the reference mean. With a Z-score of -1.00 (15.9th percentile), this represents mild atrophy. ",
  "text_data": "Age is 76.4 years. Gender is Female. Education: 16 years. MMSE: 29.0. MoCA: 29.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the entorhinal cortex (Z-score -2.12, 1.7th percentile) and moderate atrophy in the fusiform gyrus (Z-score -1.60, 5.5th percentile), both key regions in Alzheimer's pathology. However, cognitive scores (MMSE 29, MoCA 29) are intact, and there is no APOE4 risk allele.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (due to structural changes despite normal cognition)  \n**Confidence:** **Medium** (high confidence in atrophy but unclear progression due to preserved cognition)  \n\n*Note: Follow-up cognitive testing and biomarker assessment (e.g., CSF Aβ/tau, PET) would strengthen diagnostic certainty.*",
  "timestamp": "2025-07-26T09:44:37.343373"
}