{
  "ptid_time": "141_S_0853_2007-03-11",
  "img_path": "/data/qiuhui/data/adni/images/141_S_0853/2007-03-11/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 48,644 mm³, 3.5% above the reference mean. With a Z-score of 0.10 (54.0th percentile), this represents normal volume ; hippocampal volume measures 5,209 mm³, 25.2% below the reference mean. With a Z-score of -2.18 (1.5th percentile), this represents significant atrophy; whole brain volume measures 919,775 mm³, 10.6% below the reference mean. With a Z-score of -1.39 (8.2th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,967 mm³, 0.1% below the reference mean. With a Z-score of -0.00 (49.9th percentile), this represents normal volume ; fusiform gyrus volume measures 15,881 mm³, 12.1% below the reference mean. With a Z-score of -1.05 (14.7th percentile), this represents mild atrophy; middle temporal gyrus volume measures 16,689 mm³, 17.3% below the reference mean. With a Z-score of -1.55 (6.1th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 87.3 years. Gender is Male. Education: 16 years. MMSE: 23.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows significant atrophy (Z-score -2.18, 1.5th percentile), which is strongly associated with Alzheimer's disease. The whole brain, fusiform gyrus, and middle temporal gyrus also show mild to moderate atrophy, further supporting neurodegenerative changes. The MMSE score of 23 suggests mild cognitive impairment, and the presence of two APOE4 alleles increases Alzheimer's risk.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**",
  "timestamp": "2025-07-26T16:51:09.466444"
}