{
  "ptid_time": "135_S_4954_2013-04-15",
  "img_path": "/data/qiuhui/data/adni/images/135_S_4954/2013-04-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 40,331 mm³, 34.3% above the reference mean. With a Z-score of 0.82 (79.3th percentile), this represents normal volume ; whole brain volume measures 1,124,980 mm³, 0.8% below the reference mean. With a Z-score of -0.12 (45.3th percentile), this represents normal volume ; entorhinal cortex volume measures 3,410 mm³, 20.0% below the reference mean. With a Z-score of -1.38 (8.3th percentile), this represents mild atrophy; fusiform gyrus volume measures 20,792 mm³, 4.4% above the reference mean. With a Z-score of 0.37 (64.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 26,630 mm³, 18.8% above the reference mean. With a Z-score of 1.55 (93.9th percentile), this represents moderate enlargement. ",
  "text_data": "Age is 61.6 years. Gender is Male. Education: 18 years. MMSE: 27.0. MoCA: 23.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows mild atrophy (Z-score -1.38, 8.3th percentile), which is an early marker of Alzheimer's pathology. Cognitive scores (MMSE 27, MoCA 23) suggest mild cognitive impairment (MCI), particularly given the MoCA score below the typical cutoff of 26. The presence of two APOE4 alleles further increases Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Cognitive scores and entorhinal atrophy support MCI, but other brain regions are normal or enlarged, and clinical correlation is needed to rule out other causes.)",
  "timestamp": "2025-07-26T15:46:55.451526"
}