{
  "ptid_time": "114_S_6039_2018-12-13",
  "img_path": "/data/qiuhui/data/adni/images/114_S_6039/2018-12-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 33,805 mm³, 35.2% above the reference mean. With a Z-score of 0.47 (68.0th percentile), this represents normal volume ; hippocampal volume measures 7,098 mm³.; whole brain volume measures 982,354 mm³, 17.6% below the reference mean. With a Z-score of -3.26 (0.1th percentile), this represents profound atrophy; entorhinal cortex volume measures 4,522 mm³, 13.0% above the reference mean. With a Z-score of 1.14 (87.2th percentile), this represents mild enlargement; fusiform gyrus volume measures 13,868 mm³, 33.5% below the reference mean. With a Z-score of -5.09 (0.0th percentile), this represents profound atrophy; middle temporal gyrus volume measures 18,206 mm³.. ",
  "text_data": "Age is 56.9 years. Gender is Male. Education: 13 years. MMSE: 21.0. MoCA: 10.0. Logical Memory: 5.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound atrophy in whole brain volume (Z-score -3.26) and fusiform gyrus (Z-score -5.09), alongside significant cognitive impairment (MMSE 21, MoCA 10). However, hippocampal volume is within normal range, and entorhinal cortex is mildly enlarged, which is atypical for typical Alzheimer's disease. The absence of APOE4 also reduces Alzheimer's likelihood.  \n\n**Diagnosis:** **Dementia** (likely non-Alzheimer's subtype, such as frontotemporal dementia given fusiform gyrus atrophy)  \n**Confidence:** **Medium** (due to atypical hippocampal/entorhinal findings but clear cognitive and structural deficits)",
  "timestamp": "2025-07-26T11:48:45.014746"
}