{
  "ptid_time": "126_S_1221_2007-08-07",
  "img_path": "/data/qiuhui/data/adni/images/126_S_1221/2007-08-07/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 61,793 mm³, 60.4% above the reference mean. With a Z-score of 1.45 (92.6th percentile), this represents mild enlargement; hippocampal volume measures 4,891 mm³, 35.3% below the reference mean. With a Z-score of -3.44 (0.0th percentile), this represents profound atrophy; whole brain volume measures 1,097,630 mm³, 1.7% above the reference mean. With a Z-score of 0.22 (58.7th percentile), this represents normal volume ; entorhinal cortex volume measures 2,446 mm³, 40.3% below the reference mean. With a Z-score of -2.74 (0.3th percentile), this represents significant atrophy; fusiform gyrus volume measures 19,247 mm³, 2.2% above the reference mean. With a Z-score of 0.18 (57.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,485 mm³, 18.1% below the reference mean. With a Z-score of -1.62 (5.2th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 71.7 years. Gender is Male. Education: 6 years. MMSE: 20.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows profound hippocampal atrophy (Z-score -3.44) and significant entorhinal cortex atrophy (Z-score -2.74), both strongly associated with Alzheimer's pathology. Moderate atrophy in the middle temporal gyrus and mild ventricular enlargement further support neurodegeneration. The MMSE score of 20 indicates cognitive impairment.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease given the hippocampal/entorhinal atrophy and APOE4 positivity).  \n\n**Confidence:** **High** (structural atrophy patterns and cognitive deficits align clearly with dementia).",
  "timestamp": "2025-07-26T12:43:05.379700"
}