{
  "ptid_time": "053_S_0507_2007-11-27",
  "img_path": "/data/qiuhui/data/adni/images/053_S_0507/2007-11-27/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 44,434 mm³, 138.6% above the reference mean. With a Z-score of 3.97 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 5,745 mm³, 26.4% below the reference mean. With a Z-score of -3.67 (0.0th percentile), this represents profound atrophy; whole brain volume measures 820,862 mm³, 21.1% below the reference mean. With a Z-score of -2.53 (0.6th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,391 mm³, 35.3% below the reference mean. With a Z-score of -2.76 (0.3th percentile), this represents significant atrophy; fusiform gyrus volume measures 12,747 mm³, 30.8% below the reference mean. With a Z-score of -2.80 (0.3th percentile), this represents significant atrophy; middle temporal gyrus volume measures 10,861 mm³, 47.1% below the reference mean. With a Z-score of -3.89 (0.0th percentile), this represents profound atrophy. ",
  "text_data": "Age is 56.7 years. Gender is Female. Education: 18 years. MMSE: 24.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound atrophy in multiple brain regions critical for memory and cognition (hippocampus, entorhinal cortex, fusiform gyrus, middle temporal gyrus) alongside significant whole-brain atrophy and ventricular enlargement. The MMSE score of 24 suggests mild cognitive impairment, but the severity of structural changes is more consistent with dementia, particularly Alzheimer's disease (AD), despite the absence of APOE4.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High** (due to extensive atrophy in AD-vulnerable regions and cognitive decline, though early age and lack of APOE4 slightly reduce specificity).",
  "timestamp": "2025-07-26T07:54:29.911869"
}