{
  "ptid_time": "027_S_2219_2018-02-06",
  "img_path": "/data/qiuhui/data/adni/images/027_S_2219/2018-02-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 51,579 mm³, 9.7% above the reference mean. With a Z-score of 0.28 (61.1th percentile), this represents normal volume ; hippocampal volume measures 6,461 mm³, 7.3% below the reference mean. With a Z-score of -0.63 (26.5th percentile), this represents normal volume ; whole brain volume measures 1,054,770 mm³, 2.5% above the reference mean. With a Z-score of 0.33 (62.8th percentile), this represents normal volume ; entorhinal cortex volume measures 2,797 mm³, 29.5% below the reference mean. With a Z-score of -1.93 (2.7th percentile), this represents moderate atrophy; fusiform gyrus volume measures 20,311 mm³, 12.4% above the reference mean. With a Z-score of 1.08 (85.9th percentile), this represents mild enlargement; middle temporal gyrus volume measures 21,642 mm³, 7.3% above the reference mean. With a Z-score of 0.65 (74.3th percentile), this represents normal volume . ",
  "text_data": "Age is 81.3 years. Gender is Male. Education: 18 years. MMSE: 30.0. MoCA: 20.0. Logical Memory: 8.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex shows moderate atrophy (Z-score -1.93, 2.7th percentile), which is a strong biomarker for early Alzheimer's pathology. However, hippocampal volume is normal (Z-score -0.63), and whole brain volume is normal. The MMSE is intact (30/30), but the MoCA (20/30) suggests mild cognitive impairment (MCI). No APOE4 risk allele is present.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting MoCA/MMSE scores and isolated entorhinal atrophy without hippocampal involvement)",
  "timestamp": "2025-07-26T03:53:40.405623"
}