{
  "ptid_time": "168_S_6467_2019-10-02",
  "img_path": "/data/qiuhui/data/adni/images/168_S_6467/2019-10-02/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 25,007 mm³, 10.9% below the reference mean. With a Z-score of -0.25 (40.1th percentile), this represents normal volume ; hippocampal volume measures 5,054 mm³, 29.0% below the reference mean. With a Z-score of -2.66 (0.4th percentile), this represents significant atrophy; whole brain volume measures 995,389 mm³, 2.1% above the reference mean. With a Z-score of 0.27 (60.6th percentile), this represents normal volume ; entorhinal cortex volume measures 2,163 mm³, 41.1% below the reference mean. With a Z-score of -2.52 (0.6th percentile), this represents significant atrophy; fusiform gyrus volume measures 14,948 mm³, 12.1% below the reference mean. With a Z-score of -1.10 (13.5th percentile), this represents mild atrophy; middle temporal gyrus volume measures 15,396 mm³, 19.7% below the reference mean. With a Z-score of -1.71 (4.4th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 72.2 years. Gender is Female. Education: 13 years. MMSE: 24.0. MoCA: 17.0. Logical Memory: 2.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in the hippocampus and entorhinal cortex, which are key regions affected in Alzheimer's disease (AD). The MMSE (24) and MoCA (17) scores indicate cognitive impairment, with the MoCA score particularly suggestive of moderate cognitive decline. The absence of APOE4 does not rule out AD, as atrophy patterns and cognitive scores are more indicative.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease)  \n**Confidence:** **High** (due to significant hippocampal/entorhinal atrophy and low MoCA score, despite normal ventricular/whole-brain volumes).",
  "timestamp": "2025-07-26T17:21:25.288508"
}