{
  "ptid_time": "011_S_0856_2007-09-25",
  "img_path": "/data/qiuhui/data/adni/images/011_S_0856/2007-09-25/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 56,826 mm³, 89.3% above the reference mean. With a Z-score of 2.12 (98.3th percentile), this represents significant enlargement; hippocampal volume measures 6,596 mm³, 17.8% below the reference mean. With a Z-score of -1.78 (3.7th percentile), this represents moderate atrophy; whole brain volume measures 1,141,370 mm³, 0.6% above the reference mean. With a Z-score of 0.09 (53.4th percentile), this represents normal volume ; entorhinal cortex volume measures 2,782 mm³, 34.7% below the reference mean. With a Z-score of -2.40 (0.8th percentile), this represents significant atrophy; fusiform gyrus volume measures 16,821 mm³, 15.5% below the reference mean. With a Z-score of -1.29 (9.9th percentile), this represents mild atrophy; middle temporal gyrus volume measures 16,879 mm³, 24.7% below the reference mean. With a Z-score of -2.03 (2.1th percentile), this represents significant atrophy. ",
  "text_data": "Age is 61.3 years. Gender is Male. Education: 13 years. MMSE: 27.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (89.3% above mean, Z=2.12) and marked atrophy in key Alzheimer’s-related regions (hippocampus, entorhinal cortex, middle temporal gyrus). The MMSE score of 27 is borderline normal, but the structural changes suggest neurodegeneration. APOE4 positivity (1 allele) further increases Alzheimer’s risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given the atrophy pattern).  \n\n**Confidence:** **High** (strong imaging evidence of atrophy in Alzheimer’s-vulnerable regions, despite near-normal MMSE).  \n\n*Note: Progression to dementia is likely if atrophy continues at this rate. Follow-up cognitive testing (e.g., MoCA) and biomarker analysis (e.g., amyloid PET/CSF) would strengthen the diagnosis.*",
  "timestamp": "2025-07-25T22:46:58.687914"
}