{
  "ptid_time": "068_S_0476_2008-01-22",
  "img_path": "/data/qiuhui/data/adni/images/068_S_0476/2008-01-22/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 40,979 mm³, 46.0% above the reference mean. With a Z-score of 1.05 (85.4th percentile), this represents mild enlargement; hippocampal volume measures 5,385 mm³, 24.3% below the reference mean. With a Z-score of -2.23 (1.3th percentile), this represents significant atrophy; whole brain volume measures 837,788 mm³, 14.0% below the reference mean. With a Z-score of -1.77 (3.9th percentile), this represents moderate atrophy; entorhinal cortex volume measures 3,387 mm³, 7.8% below the reference mean. With a Z-score of -0.48 (31.6th percentile), this represents normal volume ; fusiform gyrus volume measures 12,362 mm³, 27.3% below the reference mean. With a Z-score of -2.49 (0.6th percentile), this represents significant atrophy; middle temporal gyrus volume measures 13,086 mm³, 31.7% below the reference mean. With a Z-score of -2.75 (0.3th percentile), this represents significant atrophy. ",
  "text_data": "Age is 77.3 years. Gender is Female. Education: 14 years. MMSE: 20.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant atrophy in the hippocampus, fusiform gyrus, and middle temporal gyrus—key regions affected in Alzheimer's disease. Combined with a low MMSE score (20/30) and APOE4 positivity, this strongly suggests cognitive impairment beyond normal aging.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**",
  "timestamp": "2025-07-26T08:49:58.800461"
}