{
  "ptid_time": "116_S_0649_2008-02-07",
  "img_path": "/data/qiuhui/data/adni/images/116_S_0649/2008-02-07/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 39,740 mm³, 15.5% below the reference mean. With a Z-score of -0.45 (32.7th percentile), this represents normal volume ; hippocampal volume measures 4,539 mm³, 34.9% below the reference mean. With a Z-score of -3.01 (0.1th percentile), this represents profound atrophy; whole brain volume measures 829,337 mm³, 19.4% below the reference mean. With a Z-score of -2.54 (0.5th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,546 mm³, 35.9% below the reference mean. With a Z-score of -2.35 (0.9th percentile), this represents significant atrophy; fusiform gyrus volume measures 13,646 mm³, 24.5% below the reference mean. With a Z-score of -2.12 (1.7th percentile), this represents significant atrophy; middle temporal gyrus volume measures 14,632 mm³, 27.5% below the reference mean. With a Z-score of -2.46 (0.7th percentile), this represents significant atrophy. ",
  "text_data": "Age is 88.2 years. Gender is Male. Education: 20 years. MMSE: 27.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound atrophy in the hippocampus and significant atrophy in the whole brain, entorhinal cortex, fusiform gyrus, and middle temporal gyrus—all key regions affected in Alzheimer's disease. Despite a normal MMSE score (27/30), the severe volumetric reductions, particularly in the hippocampus (Z-score -3.01), strongly suggest neurodegenerative pathology. The presence of one APOE4 allele further supports Alzheimer's risk.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**  \n\n*(Note: While the MMSE is normal, the structural atrophy is severe and disproportionate to age, indicating probable dementia with atypical presentation or very early cognitive symptoms.)*",
  "timestamp": "2025-07-26T11:56:21.290758"
}