{
  "ptid_time": "051_S_4929_2013-10-02",
  "img_path": "/data/qiuhui/data/adni/images/051_S_4929/2013-10-02/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 54,618 mm³, 94.6% above the reference mean. With a Z-score of 2.17 (98.5th percentile), this represents significant enlargement; hippocampal volume measures 4,824 mm³, 32.2% below the reference mean. With a Z-score of -2.95 (0.2th percentile), this represents significant atrophy; whole brain volume measures 836,908 mm³, 14.1% below the reference mean. With a Z-score of -1.78 (3.8th percentile), this represents moderate atrophy; entorhinal cortex volume measures 2,591 mm³, 29.5% below the reference mean. With a Z-score of -1.81 (3.5th percentile), this represents moderate atrophy; fusiform gyrus volume measures 9,019 mm³, 47.0% below the reference mean. With a Z-score of -4.28 (0.0th percentile), this represents profound atrophy; middle temporal gyrus volume measures 14,706 mm³, 23.3% below the reference mean. With a Z-score of -2.02 (2.2th percentile), this represents significant atrophy. ",
  "text_data": "Age is 76.7 years. Gender is Female. Education: 15 years. MMSE: 26.0. MoCA: 18.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in key Alzheimer's-related regions (hippocampus, fusiform gyrus, entorhinal cortex, middle temporal gyrus) alongside ventricular enlargement, consistent with neurodegeneration. The MoCA score of 18 (below the typical MCI cutoff of 26) and preserved MMSE (26) suggest cognitive impairment, likely beyond MCI.  \n**Diagnosis:** Dementia (likely Alzheimer’s disease)  \n**Confidence:** High  \n\n*(Note: APOE4 positivity further supports Alzheimer’s pathology, though clinical correlation with biomarkers like CSF/amyloid PET would strengthen certainty.)*",
  "timestamp": "2025-07-26T07:37:35.428982"
}