{
  "ptid_time": "018_S_0633_2006-06-15",
  "img_path": "/data/qiuhui/data/adni/images/018_S_0633/2006-06-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 40,535 mm³, 13.8% below the reference mean. With a Z-score of -0.40 (34.4th percentile), this represents normal volume ; hippocampal volume measures 4,679 mm³, 32.9% below the reference mean. With a Z-score of -2.84 (0.2th percentile), this represents significant atrophy; whole brain volume measures 836,760 mm³, 18.7% below the reference mean. With a Z-score of -2.45 (0.7th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,161 mm³, 45.6% below the reference mean. With a Z-score of -2.98 (0.1th percentile), this represents significant atrophy; fusiform gyrus volume measures 13,221 mm³, 26.8% below the reference mean. With a Z-score of -2.32 (1.0th percentile), this represents significant atrophy; middle temporal gyrus volume measures 14,034 mm³, 30.4% below the reference mean. With a Z-score of -2.73 (0.3th percentile), this represents significant atrophy. ",
  "text_data": "Age is 83.3 years. Gender is Male. Education: 11 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Renal-Genitourinary; Allergies or Drug Sensitivities. MMSE: 20.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in key Alzheimer's-related regions (hippocampus, entorhinal cortex, fusiform gyrus, middle temporal gyrus) with Z-scores below -2.0, indicating severe volume loss. The MMSE score of 20 suggests cognitive impairment, and the presence of one APOE4 allele increases Alzheimer's risk.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease)  \n**Confidence:** **High** (due to severe atrophy in AD-vulnerable regions, low MMSE, and APOE4 carrier status).",
  "timestamp": "2025-07-26T00:51:22.834171"
}