{
  "ptid_time": "128_S_0528_2006-05-17",
  "img_path": "/data/qiuhui/data/adni/images/128_S_0528/2006-05-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 24,653 mm³, 12.2% below the reference mean. With a Z-score of -0.28 (39.0th percentile), this represents normal volume ; hippocampal volume measures 4,701 mm³, 33.9% below the reference mean. With a Z-score of -3.11 (0.1th percentile), this represents profound atrophy; whole brain volume measures 868,793 mm³, 10.9% below the reference mean. With a Z-score of -1.37 (8.6th percentile), this represents mild atrophy; entorhinal cortex volume measures 1,964 mm³, 46.5% below the reference mean. With a Z-score of -2.86 (0.2th percentile), this represents significant atrophy; fusiform gyrus volume measures 13,502 mm³, 20.6% below the reference mean. With a Z-score of -1.88 (3.0th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 17,848 mm³, 6.9% below the reference mean. With a Z-score of -0.60 (27.5th percentile), this represents normal volume . ",
  "text_data": "Age is 70.8 years. Gender is Female. Education: 13 years. Handedness: Right. Race: White. Medical history: Psychiatric; Musculoskeletal; Renal-Genitourinary; Alcohol Abuse; Smoking; Major Surgical Procedures. MMSE: 21.0. Logical Memory: 4.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient exhibits profound hippocampal atrophy (Z-score -3.11, 0.1th percentile) and significant entorhinal cortex atrophy (Z-score -2.86, 0.2th percentile), both strongly associated with Alzheimer's pathology. The MMSE score of 21 indicates cognitive impairment, and the absence of APOE4 does not rule out AD, as neurodegeneration is already evident.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease given the hippocampal/entorhinal atrophy pattern).  \n\n**Confidence:** **High** (structural atrophy aligns with clinical cognitive decline).",
  "timestamp": "2025-07-26T13:46:12.608379"
}