{
  "ptid_time": "003_S_1059_2008-12-23",
  "img_path": "/data/qiuhui/data/adni/images/003_S_1059/2008-12-23/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 75,900 mm³, 105.3% above the reference mean. With a Z-score of 2.84 (99.8th percentile), this represents significant enlargement; hippocampal volume measures 4,622 mm³, 28.8% below the reference mean. With a Z-score of -2.31 (1.0th percentile), this represents significant atrophy; whole brain volume measures 794,230 mm³, 14.4% below the reference mean. With a Z-score of -1.73 (4.2th percentile), this represents moderate atrophy; entorhinal cortex volume measures 1,866 mm³, 46.1% below the reference mean. With a Z-score of -2.49 (0.6th percentile), this represents significant atrophy; fusiform gyrus volume measures 14,005 mm³, 13.1% below the reference mean. With a Z-score of -0.98 (16.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,598 mm³, 7.9% below the reference mean. With a Z-score of -0.71 (24.0th percentile), this represents normal volume . ",
  "text_data": "Age is 86.5 years. Gender is Female. Education: 18 years. MMSE: 24.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant hippocampal and entorhinal cortex atrophy, along with moderate whole-brain atrophy and severe ventricular enlargement—all hallmarks of neurodegenerative disease, likely Alzheimer’s. The MMSE score of 24 suggests mild cognitive impairment, but the degree of atrophy (especially in memory-critical regions) is more consistent with dementia.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease given the hippocampal/entorhinal atrophy, despite no APOE4).  \n\n**Confidence:** **High** (severe atrophy in AD-specific regions + clinical correlation).",
  "timestamp": "2025-07-25T20:44:11.215349"
}