{
  "ptid_time": "037_S_1078_2008-08-18",
  "img_path": "/data/qiuhui/data/adni/images/037_S_1078/2008-08-18/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 20,961 mm³, 45.6% below the reference mean. With a Z-score of -1.09 (13.7th percentile), this represents mild atrophy; hippocampal volume measures 5,893 mm³, 22.0% below the reference mean. With a Z-score of -2.15 (1.6th percentile), this represents significant atrophy; whole brain volume measures 967,443 mm³, 10.4% below the reference mean. With a Z-score of -1.35 (8.9th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,000 mm³, 26.8% below the reference mean. With a Z-score of -1.82 (3.4th percentile), this represents moderate atrophy; fusiform gyrus volume measures 17,343 mm³, 7.9% below the reference mean. With a Z-score of -0.68 (24.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,807 mm³, 11.9% below the reference mean. With a Z-score of -1.07 (14.3th percentile), this represents mild atrophy. ",
  "text_data": "Age is 72.1 years. Gender is Male. Education: 16 years. MMSE: 22.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant hippocampal atrophy (Z-score -2.15, 1.6th percentile) and moderate entorhinal cortex atrophy (Z-score -1.82, 3.4th percentile), both key regions in Alzheimer's pathology. Combined with mild whole-brain atrophy, an MMSE score of 22 (indicating cognitive impairment), and APOE4 homozygosity (high genetic risk), this strongly suggests neurodegenerative disease.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease)  \n**Confidence:** **High**",
  "timestamp": "2025-07-26T06:35:46.054086"
}