{
  "ptid_time": "005_S_0324_2008-05-05",
  "img_path": "/data/qiuhui/data/adni/images/005_S_0324/2008-05-05/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 16,699 mm³, 40.5% below the reference mean. With a Z-score of -0.93 (17.7th percentile), this represents normal volume ; hippocampal volume measures 4,578 mm³, 35.7% below the reference mean. With a Z-score of -3.27 (0.1th percentile), this represents profound atrophy; whole brain volume measures 878,183 mm³, 9.9% below the reference mean. With a Z-score of -1.25 (10.6th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,442 mm³, 33.5% below the reference mean. With a Z-score of -2.06 (2.0th percentile), this represents significant atrophy; fusiform gyrus volume measures 12,056 mm³, 29.1% below the reference mean. With a Z-score of -2.65 (0.4th percentile), this represents significant atrophy; middle temporal gyrus volume measures 14,412 mm³, 24.8% below the reference mean. With a Z-score of -2.15 (1.6th percentile), this represents significant atrophy. ",
  "text_data": "Age is 77.3 years. Gender is Female. Education: 14 years. MMSE: 24.0. Logical Memory: 0.0. Laboratory findings: . APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound hippocampal atrophy (Z-score -3.27, 0.1th percentile) and significant atrophy in the entorhinal cortex, fusiform gyrus, and middle temporal gyrus, all of which are key regions affected in Alzheimer's disease. The MMSE score of 24 suggests mild cognitive impairment, and the absence of APOE4 does not rule out AD, as neurodegeneration is already evident.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High** (due to severe atrophy in AD-vulnerable regions and cognitive decline)",
  "timestamp": "2025-07-25T21:05:42.459850"
}