{
  "ptid_time": "141_S_1004_2008-05-09",
  "img_path": "/data/qiuhui/data/adni/images/141_S_1004/2008-05-09/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 54,427 mm³, 93.9% above the reference mean. With a Z-score of 2.15 (98.4th percentile), this represents significant enlargement; hippocampal volume measures 5,559 mm³, 21.9% below the reference mean. With a Z-score of -2.01 (2.2th percentile), this represents significant atrophy; whole brain volume measures 842,233 mm³, 13.6% below the reference mean. With a Z-score of -1.71 (4.4th percentile), this represents moderate atrophy; entorhinal cortex volume measures 1,780 mm³, 51.5% below the reference mean. With a Z-score of -3.16 (0.1th percentile), this represents profound atrophy; fusiform gyrus volume measures 14,733 mm³, 13.4% below the reference mean. With a Z-score of -1.22 (11.1th percentile), this represents mild atrophy; middle temporal gyrus volume measures 17,184 mm³, 10.4% below the reference mean. With a Z-score of -0.90 (18.4th percentile), this represents normal volume . ",
  "text_data": "Age is 75.4 years. Gender is Female. Education: 12 years. MMSE: 22.0. Laboratory findings: Alkaline Phosphatase: 120.00 (significant elevated). APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant hippocampal and entorhinal cortex atrophy, both key regions in Alzheimer's pathology, alongside ventricular enlargement and whole-brain volume loss. The MMSE score of 22 indicates cognitive impairment, and the presence of one APOE4 allele increases Alzheimer's risk.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease)  \n**Confidence:** **High** (due to severe atrophy in AD-vulnerable regions, cognitive decline, and APOE4 status)",
  "timestamp": "2025-07-26T16:52:53.041735"
}