{
  "ptid_time": "002_S_0955_2006-10-11",
  "img_path": "/data/qiuhui/data/adni/images/002_S_0955/2006-10-11/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 52,258 mm³, 86.2% above the reference mean. With a Z-score of 1.97 (97.6th percentile), this represents moderate enlargement; hippocampal volume measures 4,839 mm³, 32.0% below the reference mean. With a Z-score of -2.93 (0.2th percentile), this represents significant atrophy; whole brain volume measures 968,992 mm³, 0.6% below the reference mean. With a Z-score of -0.07 (47.1th percentile), this represents normal volume ; entorhinal cortex volume measures 2,087 mm³, 43.2% below the reference mean. With a Z-score of -2.65 (0.4th percentile), this represents significant atrophy; fusiform gyrus volume measures 13,070 mm³, 23.2% below the reference mean. With a Z-score of -2.11 (1.7th percentile), this represents significant atrophy; middle temporal gyrus volume measures 16,776 mm³, 12.5% below the reference mean. With a Z-score of -1.08 (13.9th percentile), this represents mild atrophy. ",
  "text_data": "Age is 78.2 years. Gender is Female. Education: 16 years. Handedness: Right. Race: More than one race. Medical history: Psychiatric; Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 21.0. 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, entorhinal cortex, fusiform gyrus) alongside moderate ventricular enlargement, consistent with neurodegeneration. The MMSE score of 21 (below the typical cutoff of 24 for cognitive normality) and the presence of one APOE4 allele further support cognitive impairment.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease given the pattern of atrophy and APOE4 status).  \n\n**Confidence:** **High** (due to clear structural atrophy in Alzheimer’s-vulnerable regions and concordant clinical findings).",
  "timestamp": "2025-07-25T20:08:43.483474"
}