{
  "ptid_time": "127_S_4240_2012-09-25",
  "img_path": "/data/qiuhui/data/adni/images/127_S_4240/2012-09-25/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 40,118 mm³, 4.2% above the reference mean. With a Z-score of 0.10 (54.0th percentile), this represents normal volume ; hippocampal volume measures 4,864 mm³, 35.7% below the reference mean. With a Z-score of -3.48 (0.0th percentile), this represents profound atrophy; whole brain volume measures 988,180 mm³, 8.5% below the reference mean. With a Z-score of -1.10 (13.6th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,301 mm³, 43.9% below the reference mean. With a Z-score of -2.98 (0.1th percentile), this represents significant atrophy; fusiform gyrus volume measures 14,136 mm³, 25.0% below the reference mean. With a Z-score of -2.13 (1.7th percentile), this represents significant atrophy; middle temporal gyrus volume measures 20,230 mm³, 5.2% below the reference mean. With a Z-score of -0.47 (32.0th percentile), this represents normal volume . ",
  "text_data": "Age is 71.8 years. Gender is Male. Education: 20 years. MMSE: 27.0. MoCA: 22.0. Logical Memory: 1.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows profound atrophy in the hippocampus and significant atrophy in the entorhinal cortex and fusiform gyrus—key regions affected in Alzheimer’s disease (AD). The MMSE score of 27 is borderline normal, but the MoCA score of 22 suggests mild cognitive impairment (MCI), consistent with early AD. The presence of two APOE4 alleles further increases AD risk.  \n\n**Diagnosis:** **MCI (likely due to Alzheimer’s pathology)**  \n**Confidence:** **High**  \n\n*(Note: While the cognitive scores alone might suggest MCI, the severe medial temporal atrophy and APOE4 homozygosity strongly point toward early AD. If follow-up shows progression, this would meet criteria for dementia due to AD.)*",
  "timestamp": "2025-07-26T13:17:28.943573"
}