{
  "ptid_time": "116_S_4195_2012-09-17",
  "img_path": "/data/qiuhui/data/adni/images/116_S_4195/2012-09-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 20,482 mm³, 31.8% below the reference mean. With a Z-score of -0.76 (22.5th percentile), this represents normal volume ; hippocampal volume measures 5,511 mm³, 31.3% below the reference mean. With a Z-score of -3.13 (0.1th percentile), this represents profound atrophy; whole brain volume measures 947,201 mm³, 16.5% below the reference mean. With a Z-score of -2.34 (1.0th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,614 mm³, 38.7% below the reference mean. With a Z-score of -2.68 (0.4th percentile), this represents significant atrophy; fusiform gyrus volume measures 15,909 mm³, 20.1% below the reference mean. With a Z-score of -1.67 (4.7th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 15,579 mm³, 30.5% below the reference mean. With a Z-score of -2.51 (0.6th percentile), this represents significant atrophy. ",
  "text_data": "Age is 63.2 years. Gender is Male. Education: 16 years. MMSE: 18.0. MoCA: 11.0. Logical Memory: 2.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient exhibits profound hippocampal atrophy (Z-score -3.13, 0.1th percentile) and significant atrophy in whole brain, entorhinal cortex, and middle temporal gyrus, alongside moderate fusiform gyrus atrophy. These findings, combined with low MMSE (18) and MoCA (11) scores, strongly suggest cognitive impairment beyond normal aging. The presence of two APOE4 alleles further supports a neurodegenerative process.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease given hippocampal and entorhinal atrophy).  \n\n**Confidence:** **High** (severe atrophy in key AD-related regions and poor cognitive scores align with dementia).",
  "timestamp": "2025-07-26T12:09:16.125347"
}