{
  "ptid_time": "127_S_1427_2011-08-19",
  "img_path": "/data/qiuhui/data/adni/images/127_S_1427/2011-08-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 22,399 mm³, 20.2% below the reference mean. With a Z-score of -0.46 (32.2th percentile), this represents normal volume ; hippocampal volume measures 7,340 mm³, 3.2% above the reference mean. With a Z-score of 0.29 (61.4th percentile), this represents normal volume ; whole brain volume measures 995,647 mm³, 2.2% above the reference mean. With a Z-score of 0.27 (60.7th percentile), this represents normal volume ; entorhinal cortex volume measures 3,287 mm³, 10.5% below the reference mean. With a Z-score of -0.64 (25.9th percentile), this represents normal volume ; fusiform gyrus volume measures 15,108 mm³, 11.2% below the reference mean. With a Z-score of -1.02 (15.4th percentile), this represents mild atrophy; middle temporal gyrus volume measures 22,459 mm³, 17.2% above the reference mean. With a Z-score of 1.49 (93.2th percentile), this represents mild enlargement. ",
  "text_data": "Age is 73.6 years. Gender is Female. Education: 12 years. Handedness: Right. Race: White. MMSE: 11.0. MoCA: 7.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are largely within normal ranges, with only mild atrophy noted in the fusiform gyrus and mild enlargement in the middle temporal gyrus. However, the MMSE (11/30) and MoCA (7/30) scores are severely impaired, strongly suggesting significant cognitive dysfunction. The absence of APOE4 reduces genetic risk but does not rule out dementia.  \n\n**Diagnosis:** **Dementia** (likely non-Alzheimer’s etiology given normal hippocampal volume and APOE4-negative status).  \n\n**Confidence:** **High** (due to severe cognitive impairment despite mostly normal structural findings).",
  "timestamp": "2025-07-26T13:09:58.799031"
}