{
  "ptid_time": "130_S_2373_2011-11-01",
  "img_path": "/data/qiuhui/data/adni/images/130_S_2373/2011-11-01/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 17,665 mm³, 37.1% below the reference mean. With a Z-score of -0.85 (19.8th percentile), this represents normal volume ; hippocampal volume measures 4,912 mm³, 31.0% below the reference mean. With a Z-score of -2.84 (0.2th percentile), this represents significant atrophy; whole brain volume measures 858,565 mm³, 11.9% below the reference mean. With a Z-score of -1.50 (6.7th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,671 mm³, 0.1% below the reference mean. With a Z-score of -0.00 (49.9th percentile), this represents normal volume ; fusiform gyrus volume measures 15,279 mm³, 10.2% below the reference mean. With a Z-score of -0.93 (17.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,358 mm³, 14.7% below the reference mean. With a Z-score of -1.27 (10.1th percentile), this represents mild atrophy. ",
  "text_data": "Age is 79.5 years. Gender is Female. Education: 13 years. MMSE: 26.0. MoCA: 19.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant hippocampal atrophy (Z-score -2.84, 0.2nd percentile) and mild whole-brain and middle temporal gyrus atrophy, alongside cognitive impairment (MoCA 19/30, MMSE 26/30). The preserved entorhinal cortex and fusiform gyrus volumes suggest a pattern typical of early Alzheimer's disease rather than frontotemporal dementia. APOE4 positivity further supports Alzheimer's pathology.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**  \n\n*(Key findings: Severe hippocampal atrophy + low MoCA + APOE4 carrier, with other regions less affected. MCI is less likely given the MoCA score, and CN is ruled out by objective cognitive decline.)*",
  "timestamp": "2025-07-26T14:36:27.043331"
}