{
  "ptid_time": "057_S_1379_2007-10-03",
  "img_path": "/data/qiuhui/data/adni/images/057_S_1379/2007-10-03/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 130,503 mm³, 177.6% above the reference mean. With a Z-score of 5.16 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 3,870 mm³, 44.5% below the reference mean. With a Z-score of -3.84 (0.0th percentile), this represents profound atrophy; whole brain volume measures 1,034,230 mm³, 0.5% above the reference mean. With a Z-score of 0.06 (52.6th percentile), this represents normal volume ; entorhinal cortex volume measures 1,143 mm³, 71.2% below the reference mean. With a Z-score of -4.66 (0.0th percentile), this represents profound atrophy; fusiform gyrus volume measures 16,220 mm³, 10.2% below the reference mean. With a Z-score of -0.88 (18.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,357 mm³, 14.0% below the reference mean. With a Z-score of -1.25 (10.6th percentile), this represents mild atrophy. ",
  "text_data": "Age is 88.2 years. Gender is Male. Education: 8 years. MMSE: 27.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound atrophy in the hippocampus and entorhinal cortex, both critical regions for memory and strongly implicated in Alzheimer's disease. Ventricular enlargement is also severe, consistent with neurodegeneration. Despite the MMSE score of 27 (within normal range), the structural changes suggest significant underlying pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given hippocampal/entorhinal atrophy, but cognitive testing is not yet impaired enough for dementia diagnosis).  \n\n**Confidence:** **High** (due to severe atrophy in Alzheimer’s-vulnerable regions, even if cognition is still relatively preserved).  \n\n*Note:* The discrepancy between imaging and MMSE could reflect cognitive reserve or early-stage disease. Close monitoring for decline is warranted. APOE4-negative status slightly reduces Alzheimer’s likelihood but does not rule it out.",
  "timestamp": "2025-07-26T08:12:33.106614"
}