{
  "ptid_time": "027_S_0404_2007-05-09",
  "img_path": "/data/qiuhui/data/adni/images/027_S_0404/2007-05-09/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 34,697 mm³, 6.1% below the reference mean. With a Z-score of -0.17 (43.4th percentile), this represents normal volume ; hippocampal volume measures 3,950 mm³, 39.2% below the reference mean. With a Z-score of -3.14 (0.1th percentile), this represents profound atrophy; whole brain volume measures 773,219 mm³, 16.7% below the reference mean. With a Z-score of -2.00 (2.3th percentile), this represents significant atrophy; entorhinal cortex volume measures 1,541 mm³, 55.5% below the reference mean. With a Z-score of -3.00 (0.1th percentile), this represents significant atrophy; fusiform gyrus volume measures 11,291 mm³, 29.9% below the reference mean. With a Z-score of -2.25 (1.2th percentile), this represents significant atrophy; middle temporal gyrus volume measures 15,416 mm³, 14.5% below the reference mean. With a Z-score of -1.29 (9.9th percentile), this represents mild atrophy. ",
  "text_data": "Age is 88.8 years. Gender is Female. Education: 14 years. MMSE: 22.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows profound atrophy in the hippocampus and entorhinal cortex, along with significant atrophy in whole brain, fusiform gyrus, and mild atrophy in the middle temporal gyrus—key regions affected in Alzheimer’s disease. The MMSE score of 22 suggests cognitive impairment, and the absence of APOE4 does not rule out AD given the structural findings.  \n\n**Diagnosis:** Dementia (likely Alzheimer’s disease)  \n**Confidence:** High",
  "timestamp": "2025-07-26T03:36:25.135886"
}