{
  "ptid_time": "022_S_1394_2011-06-23",
  "img_path": "/data/qiuhui/data/adni/images/022_S_1394/2011-06-23/t1.nii.gz",
  "img_finding": "Image findings: hippocampal volume measures 6,597 mm³, 5.3% below the reference mean. With a Z-score of -0.46 (32.3th percentile), this represents normal volume ; whole brain volume measures 975,954 mm³, 5.2% below the reference mean. With a Z-score of -0.68 (24.9th percentile), this represents normal volume ; entorhinal cortex volume measures 2,500 mm³, 37.0% below the reference mean. With a Z-score of -2.42 (0.8th percentile), this represents significant atrophy; fusiform gyrus volume measures 11,752 mm³, 34.9% below the reference mean. With a Z-score of -3.03 (0.1th percentile), this represents profound atrophy; middle temporal gyrus volume measures 14,500 mm³, 28.1% below the reference mean. With a Z-score of -2.52 (0.6th percentile), this represents significant atrophy. ",
  "text_data": "Age is 81.1 years. Gender is Male. Education: 18 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Respiratory; Musculoskeletal; Gastrointestinal; Allergies or Drug Sensitivities. MMSE: 7.0. MoCA: 5.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in the entorhinal cortex, fusiform gyrus, and middle temporal gyrus—key regions affected in Alzheimer’s disease (AD). Hippocampal and whole-brain volumes are within normal limits, but the severe cognitive impairment (MMSE: 7, MoCA: 5) strongly suggests dementia. The APOE4 carrier status further supports AD risk.  \n**Diagnosis:** Dementia (likely Alzheimer’s disease)  \n**Confidence:** High",
  "timestamp": "2025-07-26T02:12:11.533060"
}