{
  "ptid_time": "007_S_4467_2012-07-30",
  "img_path": "/data/qiuhui/data/adni/images/007_S_4467/2012-07-30/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 14,491 mm³, 35.1% below the reference mean. With a Z-score of -0.88 (19.0th percentile), this represents normal volume ; hippocampal volume measures 7,216 mm³, 6.1% below the reference mean. With a Z-score of -0.68 (24.7th percentile), this represents normal volume ; whole brain volume measures 1,029,670 mm³, 0.0% above the reference mean. With a Z-score of 0.01 (50.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,054 mm³, 21.6% below the reference mean. With a Z-score of -1.67 (4.7th percentile), this represents moderate atrophy; fusiform gyrus volume measures 19,365 mm³, 6.3% above the reference mean. With a Z-score of 0.71 (76.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,448 mm³, 10.1% below the reference mean. With a Z-score of -0.90 (18.5th percentile), this represents normal volume . ",
  "text_data": "Age is 62.4 years. Gender is Female. Education: 12 years. MMSE: 27.0. MoCA: 24.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows moderate atrophy (Z-score -1.67, 4.7th percentile), which is a strong early biomarker for Alzheimer’s disease, while other brain volumes are within normal ranges. Cognitive scores (MMSE 27, MoCA 24) are borderline, with MoCA slightly below the typical cutoff for normality (26), suggesting possible mild cognitive impairment (MCI). The presence of two APOE4 alleles further increases Alzheimer’s risk.  \n\n**Diagnosis:** **MCI** (likely prodromal Alzheimer’s given entorhinal atrophy and APOE4 status).  \n\n**Confidence:** **Medium** (cognitive scores are not severely impaired, but biomarker and genetic risk support early neurodegenerative changes).",
  "timestamp": "2025-07-25T22:00:57.470811"
}