{
  "ptid_time": "109_S_1192_2007-01-11",
  "img_path": "/data/qiuhui/data/adni/images/109_S_1192/2007-01-11/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 17,623 mm³, 21.1% below the reference mean. With a Z-score of -0.53 (29.9th percentile), this represents normal volume ; hippocampal volume measures 5,738 mm³, 25.3% below the reference mean. With a Z-score of -2.84 (0.2th percentile), this represents significant atrophy; whole brain volume measures 929,185 mm³, 9.7% below the reference mean. With a Z-score of -1.21 (11.3th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,352 mm³, 39.6% below the reference mean. With a Z-score of -3.07 (0.1th percentile), this represents profound atrophy; fusiform gyrus volume measures 12,044 mm³, 33.9% below the reference mean. With a Z-score of -3.81 (0.0th percentile), this represents profound atrophy; middle temporal gyrus volume measures 21,035 mm³, 2.5% above the reference mean. With a Z-score of 0.22 (58.8th percentile), this represents normal volume . ",
  "text_data": "Age is 69.6 years. Gender is Female. Education: 14 years. MMSE: 20.0. Logical Memory: 4.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in key Alzheimer's-related regions (hippocampus, entorhinal cortex, fusiform gyrus) with Z-scores ≤ -2.84, alongside mild whole-brain atrophy. The MMSE score of 20 indicates cognitive impairment, and the presence of one APOE4 allele increases Alzheimer's risk.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer's disease)  \n**Confidence:** **High** (due to severe atrophy in AD-specific regions, low MMSE, and APOE4 status)",
  "timestamp": "2025-07-26T11:31:08.453260"
}