{
  "ptid_time": "109_S_1157_2009-01-14",
  "img_path": "/data/qiuhui/data/adni/images/109_S_1157/2009-01-14/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 45,786 mm³, 23.9% above the reference mean. With a Z-score of 0.64 (74.0th percentile), this represents normal volume ; hippocampal volume measures 4,109 mm³, 36.7% below the reference mean. With a Z-score of -2.94 (0.2th percentile), this represents significant atrophy; whole brain volume measures 778,801 mm³, 16.1% below the reference mean. With a Z-score of -1.93 (2.7th percentile), this represents moderate atrophy; entorhinal cortex volume measures 1,707 mm³, 50.7% below the reference mean. With a Z-score of -2.74 (0.3th percentile), this represents significant atrophy; fusiform gyrus volume measures 9,227 mm³, 42.7% below the reference mean. With a Z-score of -3.21 (0.1th percentile), this represents profound atrophy; middle temporal gyrus volume measures 12,855 mm³, 28.7% below the reference mean. With a Z-score of -2.55 (0.5th percentile), this represents significant atrophy. ",
  "text_data": "Age is 86.9 years. Gender is Female. Education: 12 years. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data reveals significant atrophy in key Alzheimer's-related regions, including the hippocampus, entorhinal cortex, fusiform gyrus, and middle temporal gyrus, all with Z-scores below -2.5 (≤0.5th percentile). Whole brain volume also shows moderate atrophy. These findings, combined with advanced age and APOE4 positivity, strongly suggest neurodegenerative pathology consistent with Alzheimer's disease.  \n\n**Diagnosis:** Dementia (likely Alzheimer's disease)  \n**Confidence:** High",
  "timestamp": "2025-07-26T11:30:30.547757"
}