{
  "ptid_time": "135_S_5015_2013-06-04",
  "img_path": "/data/qiuhui/data/adni/images/135_S_5015/2013-06-04/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 45,581 mm³, 62.4% above the reference mean. With a Z-score of 1.43 (92.3th percentile), this represents mild enlargement; hippocampal volume measures 5,690 mm³, 20.0% below the reference mean. With a Z-score of -1.84 (3.3th percentile), this represents moderate atrophy; whole brain volume measures 945,628 mm³, 3.0% below the reference mean. With a Z-score of -0.37 (35.4th percentile), this represents normal volume ; entorhinal cortex volume measures 2,401 mm³, 34.6% below the reference mean. With a Z-score of -2.13 (1.7th percentile), this represents significant atrophy; fusiform gyrus volume measures 15,572 mm³, 8.5% below the reference mean. With a Z-score of -0.77 (22.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 15,290 mm³, 20.2% below the reference mean. With a Z-score of -1.76 (3.9th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 78.3 years. Gender is Female. Education: 14 years. MMSE: 22.0. MoCA: 12.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the hippocampus and entorhinal cortex, both critical regions for memory and early Alzheimer's pathology, along with moderate atrophy in the middle temporal gyrus. Ventricular enlargement further supports neurodegeneration. Clinically, the patient has low MMSE (22) and very low MoCA (12) scores, consistent with cognitive impairment. The presence of one APOE4 allele increases Alzheimer's risk.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease given the pattern of atrophy and cognitive scores).  \n\n**Confidence:** **High** (clear structural and functional deficits aligning with dementia).",
  "timestamp": "2025-07-26T15:47:23.244058"
}