{
  "ptid_time": "023_S_0042_2008-12-05",
  "img_path": "/data/qiuhui/data/adni/images/023_S_0042/2008-12-05/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 58,368 mm³, 51.5% above the reference mean. With a Z-score of 1.23 (89.2th percentile), this represents mild enlargement; hippocampal volume measures 3,490 mm³, 53.8% below the reference mean. With a Z-score of -5.25 (0.0th percentile), this represents profound atrophy; whole brain volume measures 910,787 mm³, 15.6% below the reference mean. With a Z-score of -2.03 (2.1th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,350 mm³, 42.7% below the reference mean. With a Z-score of -2.90 (0.2th percentile), this represents significant atrophy; fusiform gyrus volume measures 17,079 mm³, 9.3% below the reference mean. With a Z-score of -0.80 (21.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 15,745 mm³, 26.2% below the reference mean. With a Z-score of -2.36 (0.9th percentile), this represents significant atrophy. ",
  "text_data": "Age is 75.8 years. Gender is Male. Education: 18 years. MMSE: 23.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "Reasoning: The patient shows profound hippocampal atrophy (Z-score -5.25) and significant atrophy in the entorhinal cortex, whole brain, and middle temporal gyrus, which are hallmark structural changes in Alzheimer's disease. The MMSE score of 23 suggests mild cognitive impairment, and the absence of APOE4 does not rule out AD, as neurodegeneration patterns strongly support the diagnosis.  \nDiagnosis: Dementia (likely Alzheimer's disease)  \nConfidence: High",
  "timestamp": "2025-07-26T02:28:44.635962"
}