{
  "ptid_time": "033_S_1283_2007-02-07",
  "img_path": "/data/qiuhui/data/adni/images/033_S_1283/2007-02-07/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 138,037 mm³, 452.0% above the reference mean. With a Z-score of 5.99 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 6,712 mm³.; whole brain volume measures 1,034,780 mm³, 13.2% below the reference mean. With a Z-score of -2.44 (0.7th percentile), this represents significant atrophy; entorhinal cortex volume measures 3,957 mm³, 1.2% below the reference mean. With a Z-score of -0.10 (46.0th percentile), this represents normal volume ; fusiform gyrus volume measures 18,352 mm³, 12.0% below the reference mean. With a Z-score of -1.82 (3.5th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 16,859 mm³.. ",
  "text_data": "Age is 59.9 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Neurologic; Cardiovascular; Musculoskeletal. MMSE: 25.0. Logical Memory: 7.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound ventricular enlargement (452% above mean, Z-score 5.99) and significant whole brain atrophy (13.2% below mean, Z-score -2.44), alongside moderate fusiform gyrus atrophy. The hippocampal volume is not explicitly compared to norms but is likely reduced given the overall atrophy pattern. The MMSE score of 25 is borderline, and the presence of one APOE4 allele increases Alzheimer's risk.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer's disease given atrophy pattern and APOE4 status).  \n\n**Confidence:** **Medium** (clinical correlation with cognitive symptoms would strengthen certainty, but structural findings strongly suggest neurodegeneration).",
  "timestamp": "2025-07-26T05:32:22.493049"
}