{
  "ptid_time": "022_S_1351_2012-04-19",
  "img_path": "/data/qiuhui/data/adni/images/022_S_1351/2012-04-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 48,923 mm³, 74.3% above the reference mean. With a Z-score of 1.70 (95.6th percentile), this represents moderate enlargement; hippocampal volume measures 5,852 mm³, 17.7% below the reference mean. With a Z-score of -1.63 (5.2th percentile), this represents moderate atrophy; whole brain volume measures 865,056 mm³, 11.2% below the reference mean. With a Z-score of -1.42 (7.8th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,981 mm³, 18.8% below the reference mean. With a Z-score of -1.16 (12.4th percentile), this represents mild atrophy; fusiform gyrus volume measures 12,293 mm³, 27.7% below the reference mean. With a Z-score of -2.53 (0.6th percentile), this represents significant atrophy; middle temporal gyrus volume measures 11,526 mm³, 39.9% below the reference mean. With a Z-score of -3.46 (0.0th percentile), this represents profound atrophy. ",
  "text_data": "Age is 76.8 years. Gender is Female. Education: 12 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Smoking; Major Surgical Procedures. MMSE: 18.0. MoCA: 7.0. Logical Memory: 0.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in key Alzheimer's-related regions (hippocampus, entorhinal cortex, fusiform gyrus, and middle temporal gyrus), with profound atrophy in the middle temporal gyrus (Z-score -3.46). The clinical scores (MMSE 18, MoCA 7) indicate severe cognitive impairment, and the presence of two APOE4 alleles further supports Alzheimer's pathology.  \n\n**Diagnosis:** Dementia (likely Alzheimer’s disease)  \n**Confidence:** High",
  "timestamp": "2025-07-26T02:10:41.900803"
}