{
  "ptid_time": "012_S_1292_2007-09-12",
  "img_path": "/data/qiuhui/data/adni/images/012_S_1292/2007-09-12/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 54,286 mm³, 40.9% above the reference mean. With a Z-score of 0.98 (83.7th percentile), this represents normal volume ; hippocampal volume measures 6,090 mm³, 19.4% below the reference mean. With a Z-score of -1.90 (2.9th percentile), this represents moderate atrophy; whole brain volume measures 1,058,740 mm³, 1.9% below the reference mean. With a Z-score of -0.25 (40.2th percentile), this represents normal volume ; entorhinal cortex volume measures 1,843 mm³, 55.1% below the reference mean. With a Z-score of -3.73 (0.0th percentile), this represents profound atrophy; fusiform gyrus volume measures 14,058 mm³, 25.4% below the reference mean. With a Z-score of -2.16 (1.5th percentile), this represents significant atrophy; middle temporal gyrus volume measures 20,361 mm³, 4.6% below the reference mean. With a Z-score of -0.41 (34.0th percentile), this represents normal volume . ",
  "text_data": "Age is 76.7 years. Gender is Male. Education: 16 years. MMSE: 21.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in the hippocampus, entorhinal cortex, and fusiform gyrus—key regions affected in Alzheimer’s disease. The MMSE score of 21 suggests cognitive impairment, but without APOE4 risk allele, the progression may be slower.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s subtype)**  \n**Confidence:** **Medium** (due to clear structural atrophy and cognitive decline, but lack of APOE4 and need for further clinical correlation)",
  "timestamp": "2025-07-25T23:09:18.227438"
}