{
  "ptid_time": "027_S_0417_2006-11-14",
  "img_path": "/data/qiuhui/data/adni/images/027_S_0417/2006-11-14/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 106,488 mm³, 126.5% above the reference mean. With a Z-score of 3.67 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 5,688 mm³, 18.4% below the reference mean. With a Z-score of -1.59 (5.6th percentile), this represents moderate atrophy; whole brain volume measures 1,128,330 mm³, 9.6% above the reference mean. With a Z-score of 1.26 (89.7th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,232 mm³, 18.6% below the reference mean. With a Z-score of -1.22 (11.2th percentile), this represents mild atrophy; fusiform gyrus volume measures 17,531 mm³, 3.0% below the reference mean. With a Z-score of -0.26 (39.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,189 mm³, 14.8% below the reference mean. With a Z-score of -1.33 (9.3th percentile), this represents mild atrophy. ",
  "text_data": "Age is 80.3 years. Gender is Male. Education: 16 years. MMSE: 23.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (Z-score 3.67) and moderate hippocampal atrophy (Z-score -1.59), both of which are strong indicators of neurodegeneration. The MMSE score of 23 (below the typical cutoff of 24-26 for normal cognition in this age group) further supports cognitive impairment.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease given hippocampal and entorhinal atrophy, APOE4 carrier status, and age).  \n\n**Confidence:** **High** (due to clear structural atrophy in key AD-related regions and borderline MMSE score).",
  "timestamp": "2025-07-26T03:38:33.066552"
}