{
  "ptid_time": "011_S_1282_2009-02-26",
  "img_path": "/data/qiuhui/data/adni/images/011_S_1282/2009-02-26/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 44,783 mm³, 59.6% above the reference mean. With a Z-score of 1.36 (91.4th percentile), this represents mild enlargement; hippocampal volume measures 4,569 mm³, 35.8% below the reference mean. With a Z-score of -3.28 (0.1th percentile), this represents profound atrophy; whole brain volume measures 806,524 mm³, 17.3% below the reference mean. With a Z-score of -2.17 (1.5th percentile), this represents significant atrophy; entorhinal cortex volume measures 1,979 mm³, 46.1% below the reference mean. With a Z-score of -2.83 (0.2th percentile), this represents significant atrophy; fusiform gyrus volume measures 14,603 mm³, 14.2% below the reference mean. With a Z-score of -1.29 (9.9th percentile), this represents mild atrophy; middle temporal gyrus volume measures 12,511 mm³, 34.7% below the reference mean. With a Z-score of -3.02 (0.1th percentile), this represents profound atrophy. ",
  "text_data": "Age is 79.0 years. Gender is Female. Education: 12 years. MMSE: 24.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows profound atrophy in the hippocampus, entorhinal cortex, and middle temporal gyrus—key regions affected in Alzheimer's disease (AD). The MMSE score of 24 suggests mild cognitive impairment, but the severe atrophy patterns are more consistent with dementia, likely AD. The absence of APOE4 does not rule out AD, as atrophy patterns are highly suggestive.  \n\n**Diagnosis:** Dementia (likely Alzheimer’s disease)  \n**Confidence:** High",
  "timestamp": "2025-07-25T22:51:30.751655"
}