{
  "ptid_time": "011_S_4547_2013-03-18",
  "img_path": "/data/qiuhui/data/adni/images/011_S_4547/2013-03-18/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 52,740 mm³, 36.9% above the reference mean. With a Z-score of 0.88 (81.2th percentile), this represents normal volume ; hippocampal volume measures 7,517 mm³, 0.6% below the reference mean. With a Z-score of -0.05 (47.8th percentile), this represents normal volume ; whole brain volume measures 1,064,300 mm³, 1.4% below the reference mean. With a Z-score of -0.18 (42.8th percentile), this represents normal volume ; entorhinal cortex volume measures 3,286 mm³, 19.9% below the reference mean. With a Z-score of -1.35 (8.9th percentile), this represents mild atrophy; fusiform gyrus volume measures 16,193 mm³, 14.0% below the reference mean. With a Z-score of -1.20 (11.6th percentile), this represents mild atrophy; middle temporal gyrus volume measures 19,126 mm³, 10.4% below the reference mean. With a Z-score of -0.93 (17.6th percentile), this represents normal volume . ",
  "text_data": "Age is 78.3 years. Gender is Male. Education: 18 years. MMSE: 28.0. MoCA: 23.0. Logical Memory: 6.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex and fusiform gyrus show mild atrophy (Z-scores -1.35 and -1.20, respectively), which are early markers of Alzheimer's pathology. However, hippocampal and whole-brain volumes are within normal limits, and cognitive scores (MMSE 28, MoCA 23) suggest only mild impairment, not dementia.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Structural changes are present but not severe, and cognitive scores are borderline for MCI vs. normal aging.)",
  "timestamp": "2025-07-25T22:58:50.726766"
}