{
  "ptid_time": "130_S_1337_2007-09-26",
  "img_path": "/data/qiuhui/data/adni/images/130_S_1337/2007-09-26/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 39,997 mm³, 3.8% above the reference mean. With a Z-score of 0.09 (53.7th percentile), this represents normal volume ; hippocampal volume measures 5,546 mm³, 26.6% below the reference mean. With a Z-score of -2.60 (0.5th percentile), this represents significant atrophy; whole brain volume measures 1,102,530 mm³, 2.1% above the reference mean. With a Z-score of 0.28 (61.0th percentile), this represents normal volume ; entorhinal cortex volume measures 4,859 mm³, 18.5% above the reference mean. With a Z-score of 1.25 (89.5th percentile), this represents mild enlargement; fusiform gyrus volume measures 19,782 mm³, 5.0% above the reference mean. With a Z-score of 0.43 (66.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,264 mm³, 14.4% below the reference mean. With a Z-score of -1.30 (9.8th percentile), this represents mild atrophy. ",
  "text_data": "Age is 71.9 years. Gender is Male. Education: 16 years. MMSE: 22.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient exhibits significant hippocampal atrophy (Z-score -2.60, 0.5th percentile), which is strongly associated with Alzheimer's disease (AD). The MMSE score of 22 suggests cognitive impairment, and the absence of APOE4 does not rule out AD. Mild atrophy in the middle temporal gyrus further supports neurodegeneration, while other regions remain largely normal.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s subtype)  \n**Confidence:** **High** (due to marked hippocampal atrophy and cognitive decline, despite normal APOE4 status).",
  "timestamp": "2025-07-26T14:36:00.563309"
}