{
  "ptid_time": "023_S_4796_2013-03-22",
  "img_path": "/data/qiuhui/data/adni/images/023_S_4796/2013-03-22/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 36,180 mm³, 28.9% above the reference mean. With a Z-score of 0.66 (74.6th percentile), this represents normal volume ; hippocampal volume measures 6,017 mm³, 15.4% below the reference mean. With a Z-score of -1.41 (7.9th percentile), this represents mild atrophy; whole brain volume measures 969,266 mm³, 0.6% below the reference mean. With a Z-score of -0.07 (47.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,159 mm³, 14.0% below the reference mean. With a Z-score of -0.86 (19.5th percentile), this represents normal volume ; fusiform gyrus volume measures 13,664 mm³, 19.7% below the reference mean. With a Z-score of -1.79 (3.7th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 15,372 mm³, 19.8% below the reference mean. With a Z-score of -1.72 (4.3th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 73.1 years. Gender is Female. Education: 16 years. MMSE: 22.0. MoCA: 18.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows mild hippocampal atrophy and moderate atrophy in the fusiform gyrus and middle temporal gyrus, which are regions commonly affected in Alzheimer's disease. The cognitive scores (MMSE: 22, MoCA: 18) indicate significant cognitive impairment, consistent with dementia rather than MCI. The absence of APOE4 does not rule out Alzheimer's, as neurodegeneration and cognitive deficits are present.  \n\n**Diagnosis:** Dementia (likely Alzheimer’s disease)  \n**Confidence:** Medium (due to clear structural and cognitive deficits, but lack of biomarker confirmation like amyloid/tau PET or CSF analysis)",
  "timestamp": "2025-07-26T03:07:57.890923"
}