{
  "ptid_time": "051_S_1331_2007-04-13",
  "img_path": "/data/qiuhui/data/adni/images/051_S_1331/2007-04-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 31,921 mm³, 13.7% above the reference mean. With a Z-score of 0.31 (62.3th percentile), this represents normal volume ; hippocampal volume measures 6,190 mm³, 13.0% below the reference mean. With a Z-score of -1.19 (11.7th percentile), this represents mild atrophy; whole brain volume measures 853,940 mm³, 12.4% below the reference mean. With a Z-score of -1.56 (5.9th percentile), this represents moderate atrophy; entorhinal cortex volume measures 3,620 mm³, 1.4% below the reference mean. With a Z-score of -0.09 (46.5th percentile), this represents normal volume ; fusiform gyrus volume measures 12,309 mm³, 27.6% below the reference mean. With a Z-score of -2.52 (0.6th percentile), this represents significant atrophy; middle temporal gyrus volume measures 11,906 mm³, 37.9% below the reference mean. With a Z-score of -3.29 (0.1th percentile), this represents profound atrophy. ",
  "text_data": "Age is 76.5 years. Gender is Female. Education: 11 years. MMSE: 26.0. Logical Memory: 3.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the fusiform gyrus and profound atrophy in the middle temporal gyrus, along with mild hippocampal and moderate whole-brain atrophy, which are strongly associated with neurodegenerative processes. The MMSE score of 26 is borderline, but the structural changes suggest cognitive impairment beyond normal aging. The absence of APOE4 does not rule out dementia, as atrophy patterns are highly suggestive.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease given temporal lobe involvement)  \n**Confidence:** **High** (due to severe atrophy in key AD-vulnerable regions despite near-normal MMSE)",
  "timestamp": "2025-07-26T07:35:49.151730"
}