{
  "ptid_time": "023_S_0916_2006-09-29",
  "img_path": "/data/qiuhui/data/adni/images/023_S_0916/2006-09-29/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 42,972 mm³, 11.6% above the reference mean. With a Z-score of 0.28 (60.9th percentile), this represents normal volume ; hippocampal volume measures 6,321 mm³, 16.4% below the reference mean. With a Z-score of -1.60 (5.5th percentile), this represents moderate atrophy; whole brain volume measures 940,085 mm³, 12.9% below the reference mean. With a Z-score of -1.68 (4.7th percentile), this represents moderate atrophy; entorhinal cortex volume measures 2,377 mm³, 42.0% below the reference mean. With a Z-score of -2.85 (0.2th percentile), this represents significant atrophy; fusiform gyrus volume measures 14,884 mm³, 21.0% below the reference mean. With a Z-score of -1.79 (3.7th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 18,248 mm³, 14.5% below the reference mean. With a Z-score of -1.30 (9.6th percentile), this represents mild atrophy. ",
  "text_data": "Age is 79.7 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Gastrointestinal; Renal-Genitourinary; Smoking; Major Surgical Procedures. MMSE: 21.0. Logical Memory: 2.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the entorhinal cortex (Z-score -2.85) and moderate atrophy in the hippocampus (Z-score -1.60), whole brain (Z-score -1.68), and fusiform gyrus (Z-score -1.79), which are key regions affected in Alzheimer’s disease. The MMSE score of 21 (below the typical cutoff of 24 for cognitive normality) and the presence of two APOE4 alleles further support a neurodegenerative process.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease)  \n**Confidence:** **High**",
  "timestamp": "2025-07-26T02:49:07.459233"
}