{
  "ptid_time": "023_S_4034_2011-11-16",
  "img_path": "/data/qiuhui/data/adni/images/023_S_4034/2011-11-16/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 28,540 mm³, 1.7% above the reference mean. With a Z-score of 0.04 (51.5th percentile), this represents normal volume ; hippocampal volume measures 4,721 mm³, 33.6% below the reference mean. With a Z-score of -3.09 (0.1th percentile), this represents profound atrophy; whole brain volume measures 909,540 mm³, 6.7% below the reference mean. With a Z-score of -0.84 (20.0th percentile), this represents normal volume ; entorhinal cortex volume measures 2,963 mm³, 19.3% below the reference mean. With a Z-score of -1.19 (11.8th percentile), this represents mild atrophy; fusiform gyrus volume measures 14,746 mm³, 13.3% below the reference mean. With a Z-score of -1.21 (11.3th percentile), this represents mild atrophy; middle temporal gyrus volume measures 16,284 mm³, 15.1% below the reference mean. With a Z-score of -1.31 (9.6th percentile), this represents mild atrophy. ",
  "text_data": "Age is 72.6 years. Gender is Female. Education: 19 years. MMSE: 25.0. MoCA: 20.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound hippocampal atrophy (Z-score -3.09, 0.1th percentile), which is strongly associated with Alzheimer's disease. Mild atrophy in the entorhinal cortex, fusiform gyrus, and middle temporal gyrus further supports neurodegenerative changes. The MMSE (25) and MoCA (20) scores indicate cognitive impairment, and the presence of two APOE4 alleles increases Alzheimer's risk.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease)  \n**Confidence:** **High**",
  "timestamp": "2025-07-26T03:00:58.805661"
}