{
  "ptid_time": "116_S_0487_2006-06-01",
  "img_path": "/data/qiuhui/data/adni/images/116_S_0487/2006-06-01/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 44,677 mm³, 16.0% above the reference mean. With a Z-score of 0.38 (64.9th percentile), this represents normal volume ; hippocampal volume measures 4,714 mm³, 37.6% below the reference mean. With a Z-score of -3.67 (0.0th percentile), this represents profound atrophy; whole brain volume measures 864,423 mm³, 19.9% below the reference mean. With a Z-score of -2.59 (0.5th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,980 mm³, 27.3% below the reference mean. With a Z-score of -1.85 (3.2th percentile), this represents moderate atrophy; fusiform gyrus volume measures 14,914 mm³, 20.8% below the reference mean. With a Z-score of -1.77 (3.8th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 16,352 mm³, 23.4% below the reference mean. With a Z-score of -2.10 (1.8th percentile), this represents significant atrophy. ",
  "text_data": "Age is 76.4 years. Gender is Male. Education: 20 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 22.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows profound hippocampal atrophy (Z-score -3.67) and significant whole brain atrophy (Z-score -2.59), along with moderate-to-significant atrophy in other key regions (entorhinal cortex, fusiform gyrus, middle temporal gyrus). The MMSE score of 22 suggests cognitive impairment, and the presence of one APOE4 allele increases Alzheimer's risk. These findings are consistent with neurodegenerative disease.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease given hippocampal and temporal lobe atrophy)  \n**Confidence:** **High** (structural atrophy aligns with cognitive decline and genetic risk)",
  "timestamp": "2025-07-26T11:54:43.406519"
}