{
  "ptid_time": "005_S_4910_2013-04-03",
  "img_path": "/data/qiuhui/data/adni/images/005_S_4910/2013-04-03/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 57,520 mm³, 55.6% above the reference mean. With a Z-score of 1.50 (93.3th percentile), this represents moderate enlargement; hippocampal volume measures 4,698 mm³, 27.7% below the reference mean. With a Z-score of -2.22 (1.3th percentile), this represents significant atrophy; whole brain volume measures 802,300 mm³, 13.6% below the reference mean. With a Z-score of -1.63 (5.2th percentile), this represents moderate atrophy; entorhinal cortex volume measures 1,495 mm³, 56.8% below the reference mean. With a Z-score of -3.07 (0.1th percentile), this represents profound atrophy; fusiform gyrus volume measures 11,441 mm³, 29.0% below the reference mean. With a Z-score of -2.18 (1.5th percentile), this represents significant atrophy; middle temporal gyrus volume measures 10,164 mm³, 43.6% below the reference mean. With a Z-score of -3.88 (0.0th percentile), this represents profound atrophy. ",
  "text_data": "Age is 81.9 years. Gender is Female. Education: 15 years. MMSE: 19.0. MoCA: 4.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in key Alzheimer's-related regions (hippocampus, entorhinal cortex, fusiform gyrus, middle temporal gyrus), alongside moderate whole-brain atrophy and ventricular enlargement. The cognitive scores (MMSE 19, MoCA 4) are severely impaired, consistent with advanced cognitive decline.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease given the pattern of atrophy, despite APOE4-negative status).  \n\n**Confidence:** **High** (due to the severity of atrophy in Alzheimer’s-vulnerable regions and profound cognitive impairment).",
  "timestamp": "2025-07-25T21:24:33.067615"
}