{
  "ptid_time": "033_S_1308_2008-02-27",
  "img_path": "/data/qiuhui/data/adni/images/033_S_1308/2008-02-27/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 57,925 mm³, 23.2% above the reference mean. With a Z-score of 0.67 (75.0th percentile), this represents normal volume ; hippocampal volume measures 5,469 mm³, 21.5% below the reference mean. With a Z-score of -1.86 (3.2th percentile), this represents moderate atrophy; whole brain volume measures 966,839 mm³, 6.1% below the reference mean. With a Z-score of -0.79 (21.4th percentile), this represents normal volume ; entorhinal cortex volume measures 2,700 mm³, 32.0% below the reference mean. With a Z-score of -2.09 (1.8th percentile), this represents significant atrophy; fusiform gyrus volume measures 12,459 mm³, 31.0% below the reference mean. With a Z-score of -2.69 (0.4th percentile), this represents significant atrophy; middle temporal gyrus volume measures 16,590 mm³, 17.8% below the reference mean. With a Z-score of -1.59 (5.6th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 80.7 years. Gender is Male. Education: 14 years. MMSE: 18.0. Logical Memory: 1.0. Laboratory findings: Total Bilirubin: 1.80 (profound elevated); Direct Bilirubin: 0.30 (significant elevated). APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the entorhinal cortex and fusiform gyrus, along with moderate atrophy in the hippocampus and middle temporal gyrus—key regions affected in Alzheimer’s disease. The MMSE score of 18 indicates substantial cognitive impairment, consistent with dementia.  \n\n**Diagnosis:** Dementia (likely Alzheimer’s disease)  \n**Confidence:** High",
  "timestamp": "2025-07-26T05:33:54.213263"
}