{
  "ptid_time": "153_S_4172_2012-03-28",
  "img_path": "/data/qiuhui/data/adni/images/153_S_4172/2012-03-28/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 60,974 mm³, 58.3% above the reference mean. With a Z-score of 1.40 (91.9th percentile), this represents mild enlargement; hippocampal volume measures 6,964 mm³, 7.9% below the reference mean. With a Z-score of -0.77 (22.1th percentile), this represents normal volume ; whole brain volume measures 1,142,950 mm³, 5.9% above the reference mean. With a Z-score of 0.76 (77.8th percentile), this represents normal volume ; entorhinal cortex volume measures 4,013 mm³, 2.1% below the reference mean. With a Z-score of -0.14 (44.2th percentile), this represents normal volume ; fusiform gyrus volume measures 20,602 mm³, 9.4% above the reference mean. With a Z-score of 0.80 (78.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,275 mm³, 0.3% below the reference mean. With a Z-score of -0.03 (48.9th percentile), this represents normal volume . ",
  "text_data": "Age is 76.3 years. Gender is Male. Education: 16 years. MMSE: 18.0. MoCA: 11.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows mild ventricular enlargement (58.3% above mean) but otherwise normal brain volumes, including hippocampal volume (only 7.9% below mean). However, cognitive scores (MMSE 18, MoCA 11) are significantly impaired, strongly suggesting cognitive decline beyond normal aging. The absence of APOE4 reduces but does not eliminate Alzheimer’s risk.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s or mixed etiology given structural findings and cognitive scores).  \n\n**Confidence:** **High** (due to clear cognitive impairment despite relatively preserved brain volumes).",
  "timestamp": "2025-07-26T17:13:37.223933"
}