{
  "ptid_time": "127_S_1427_2018-10-12",
  "img_path": "/data/qiuhui/data/adni/images/127_S_1427/2018-10-12/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 32,752 mm³, 11.4% below the reference mean. With a Z-score of -0.31 (37.9th percentile), this represents normal volume ; hippocampal volume measures 7,455 mm³, 14.8% above the reference mean. With a Z-score of 1.18 (88.2th percentile), this represents mild enlargement; whole brain volume measures 1,011,000 mm³, 8.9% above the reference mean. With a Z-score of 1.07 (85.8th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,732 mm³, 7.8% above the reference mean. With a Z-score of 0.42 (66.3th percentile), this represents normal volume ; fusiform gyrus volume measures 15,002 mm³, 6.9% below the reference mean. With a Z-score of -0.52 (30.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,111 mm³, 17.1% above the reference mean. With a Z-score of 1.52 (93.6th percentile), this represents moderate enlargement. ",
  "text_data": "Age is 80.6 years. Gender is Female. Education: 12 years. MMSE: 17.0. MoCA: 9.0. Logical Memory: 3.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows mild to moderate enlargement in several regions (hippocampus, whole brain, middle temporal gyrus), which is atypical for Alzheimer's disease (AD), where atrophy is expected. However, the cognitive scores (MMSE 17, MoCA 9) are severely impaired, strongly suggesting dementia. The absence of APOE4 reduces AD likelihood, but other dementias (e.g., vascular, frontotemporal) remain possible.  \n\n**Diagnosis:** Dementia  \n**Confidence:** Medium (due to conflicting imaging and cognitive findings, but cognitive impairment is severe enough to meet dementia criteria).",
  "timestamp": "2025-07-26T13:10:47.724587"
}