{
  "ptid_time": "114_S_0979_2007-05-29",
  "img_path": "/data/qiuhui/data/adni/images/114_S_0979/2007-05-29/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 65,356 mm³, 39.0% above the reference mean. With a Z-score of 1.13 (87.1th percentile), this represents mild enlargement; hippocampal volume measures 4,492 mm³, 35.5% below the reference mean. With a Z-score of -3.07 (0.1th percentile), this represents profound atrophy; whole brain volume measures 855,550 mm³, 16.9% below the reference mean. With a Z-score of -2.21 (1.4th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,618 mm³, 34.0% below the reference mean. With a Z-score of -2.23 (1.3th percentile), this represents significant atrophy; fusiform gyrus volume measures 16,485 mm³, 8.8% below the reference mean. With a Z-score of -0.76 (22.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 14,916 mm³, 26.1% below the reference mean. With a Z-score of -2.34 (1.0th percentile), this represents significant atrophy. ",
  "text_data": "Age is 86.7 years. Gender is Male. Education: 18 years. MMSE: 19.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows profound hippocampal atrophy (Z-score -3.07), significant whole brain and entorhinal cortex atrophy, and mild ventricular enlargement—all consistent with Alzheimer’s pathology. The MMSE score of 19 indicates moderate cognitive impairment, and the presence of one APOE4 allele further supports Alzheimer’s risk.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease)  \n**Confidence:** **High**",
  "timestamp": "2025-07-26T11:43:05.899327"
}