{
  "ptid_time": "137_S_4258_2012-04-27",
  "img_path": "/data/qiuhui/data/adni/images/137_S_4258/2012-04-27/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 43,340 mm³, 12.5% above the reference mean. With a Z-score of 0.30 (61.8th percentile), this represents normal volume ; whole brain volume measures 1,235,900 mm³, 14.5% above the reference mean. With a Z-score of 1.88 (97.0th percentile), this represents moderate enlargement; entorhinal cortex volume measures 3,175 mm³, 22.6% below the reference mean. With a Z-score of -1.53 (6.3th percentile), this represents moderate atrophy; fusiform gyrus volume measures 19,879 mm³, 5.5% above the reference mean. With a Z-score of 0.47 (68.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,707 mm³, 1.7% above the reference mean. With a Z-score of 0.16 (56.2th percentile), this represents normal volume . ",
  "text_data": "Age is 76.3 years. Gender is Male. Education: 14 years. MMSE: 23.0. MoCA: 20.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows moderate atrophy (Z-score -1.53, 6.3th percentile), which is a key early marker of Alzheimer's pathology. Cognitive scores (MMSE 23, MoCA 20) are below normal for age, suggesting cognitive impairment. However, whole brain volume is enlarged (Z-score 1.88), which is atypical for typical Alzheimer’s progression.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting imaging findings—entorhinal atrophy supports neurodegeneration, but enlarged whole brain volume is unusual and may suggest a mixed or atypical pathology).",
  "timestamp": "2025-07-26T16:29:02.311340"
}