{
  "ptid_time": "109_S_0950_2007-12-17",
  "img_path": "/data/qiuhui/data/adni/images/109_S_0950/2007-12-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 92,397 mm³, 139.9% above the reference mean. With a Z-score of 3.35 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 5,264 mm³, 30.4% below the reference mean. With a Z-score of -2.96 (0.2th percentile), this represents significant atrophy; whole brain volume measures 878,867 mm³, 18.6% below the reference mean. With a Z-score of -2.41 (0.8th percentile), this represents significant atrophy; entorhinal cortex volume measures 3,037 mm³, 25.9% below the reference mean. With a Z-score of -1.76 (3.9th percentile), this represents moderate atrophy; fusiform gyrus volume measures 13,969 mm³, 25.8% below the reference mean. With a Z-score of -2.20 (1.4th percentile), this represents significant atrophy; middle temporal gyrus volume measures 13,984 mm³, 34.5% below the reference mean. With a Z-score of -3.10 (0.1th percentile), this represents profound atrophy. ",
  "text_data": "Age is 74.5 years. Gender is Male. Education: 17 years. MMSE: 25.0. Logical Memory: 13.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows profound ventricular enlargement and significant atrophy in multiple brain regions, including the hippocampus, whole brain, entorhinal cortex, fusiform gyrus, and middle temporal gyrus—all key areas affected in Alzheimer's disease. The MMSE score of 25 is borderline for mild cognitive impairment (MCI), but the extensive atrophy suggests progression beyond MCI.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease subtype)**  \n**Confidence:** **High** (due to severe atrophy in AD-vulnerable regions despite borderline MMSE and no APOE4 risk allele)",
  "timestamp": "2025-07-26T11:28:14.015680"
}