{
  "ptid_time": "023_S_1247_2007-08-02",
  "img_path": "/data/qiuhui/data/adni/images/023_S_1247/2007-08-02/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 42,639 mm³, 51.9% above the reference mean. With a Z-score of 1.19 (88.3th percentile), this represents mild enlargement; hippocampal volume measures 5,776 mm³, 18.8% below the reference mean. With a Z-score of -1.73 (4.2th percentile), this represents moderate atrophy; whole brain volume measures 876,077 mm³, 10.1% below the reference mean. With a Z-score of -1.27 (10.1th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,872 mm³, 21.8% below the reference mean. With a Z-score of -1.34 (9.0th percentile), this represents mild atrophy; fusiform gyrus volume measures 15,047 mm³, 11.6% below the reference mean. With a Z-score of -1.05 (14.6th percentile), this represents mild atrophy; middle temporal gyrus volume measures 15,489 mm³, 19.2% below the reference mean. With a Z-score of -1.67 (4.8th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 73.0 years. Gender is Female. Education: 9 years. MMSE: 18.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant atrophy in key Alzheimer's-related regions, including the hippocampus (moderate atrophy, Z-score -1.73) and middle temporal gyrus (moderate atrophy, Z-score -1.67), alongside mild atrophy in the entorhinal cortex, whole brain, and fusiform gyrus. The MMSE score of 18 indicates substantial cognitive impairment, consistent with dementia. The absence of APOE4 does not rule out Alzheimer's, as atrophy patterns and cognitive decline are strongly suggestive.  \n\n**Diagnosis:** Dementia  \n**Confidence:** High",
  "timestamp": "2025-07-26T02:56:56.759547"
}