{
  "ptid_time": "033_S_0906_2011-10-12",
  "img_path": "/data/qiuhui/data/adni/images/033_S_0906/2011-10-12/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 39,997 mm³, 42.5% above the reference mean. With a Z-score of 0.97 (83.5th percentile), this represents normal volume ; hippocampal volume measures 4,913 mm³, 30.9% below the reference mean. With a Z-score of -2.84 (0.2th percentile), this represents significant atrophy; whole brain volume measures 805,446 mm³, 17.4% below the reference mean. With a Z-score of -2.19 (1.4th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,601 mm³, 29.2% below the reference mean. With a Z-score of -1.79 (3.7th percentile), this represents moderate atrophy; fusiform gyrus volume measures 12,511 mm³, 26.5% below the reference mean. With a Z-score of -2.41 (0.8th percentile), this represents significant atrophy; middle temporal gyrus volume measures 11,325 mm³, 40.9% below the reference mean. With a Z-score of -3.55 (0.0th percentile), this represents profound atrophy. ",
  "text_data": "Age is 70.3 years. Gender is Female. Education: 12 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Cardiovascular; Respiratory; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Hematopoietic-Lymphatic; Allergies or Drug Sensitivities; Malignancy; Major Surgical Procedures. MMSE: 19.0. MoCA: 12.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in key Alzheimer's-related regions (hippocampus, whole brain, fusiform gyrus, middle temporal gyrus) with Z-scores well below normal (≤ -2.19). Clinically, the patient has low MMSE (19) and MoCA (12) scores, consistent with cognitive impairment. The presence of one APOE4 allele further supports Alzheimer's risk.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease given the hippocampal and temporal lobe atrophy).  \n\n**Confidence:** **High** (due to concordance between structural atrophy patterns, low cognitive scores, and APOE4 status).",
  "timestamp": "2025-07-26T05:21:55.895347"
}