{
  "ptid_time": "002_S_2010_2013-07-18",
  "img_path": "/data/qiuhui/data/adni/images/002_S_2010/2013-07-18/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 16,116 mm³, 27.9% below the reference mean. With a Z-score of -0.70 (24.3th percentile), this represents normal volume ; hippocampal volume measures 7,710 mm³, 0.3% above the reference mean. With a Z-score of 0.04 (51.5th percentile), this represents normal volume ; whole brain volume measures 948,056 mm³, 7.9% below the reference mean. With a Z-score of -0.98 (16.3th percentile), this represents normal volume ; entorhinal cortex volume measures 3,250 mm³, 16.5% below the reference mean. With a Z-score of -1.28 (10.0th percentile), this represents mild atrophy; fusiform gyrus volume measures 15,412 mm³, 15.4% below the reference mean. With a Z-score of -1.73 (4.2th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 19,111 mm³, 6.9% below the reference mean. With a Z-score of -0.61 (27.1th percentile), this represents normal volume . ",
  "text_data": "Age is 65.9 years. Gender is Female. Education: 20 years. MMSE: 30.0. MoCA: 23.0. Logical Memory: 17.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain imaging shows mild to moderate atrophy in the entorhinal cortex and fusiform gyrus, which are regions vulnerable to Alzheimer's pathology. However, hippocampal and whole-brain volumes are within normal ranges, and the MMSE score is intact (30/30), though the MoCA (23/30) suggests mild cognitive impairment (MCI). The presence of one APOE4 allele increases Alzheimer's risk but does not confirm dementia.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting MoCA and MMSE scores, along with focal atrophy but preserved hippocampal volume)",
  "timestamp": "2025-07-25T20:18:17.164759"
}