{
  "ptid_time": "013_S_0240_2007-10-24",
  "img_path": "/data/qiuhui/data/adni/images/013_S_0240/2007-10-24/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 51,682 mm³, 9.9% above the reference mean. With a Z-score of 0.29 (61.3th percentile), this represents normal volume ; hippocampal volume measures 5,235 mm³, 24.9% below the reference mean. With a Z-score of -2.15 (1.6th percentile), this represents significant atrophy; whole brain volume measures 954,428 mm³, 7.3% below the reference mean. With a Z-score of -0.95 (17.1th percentile), this represents normal volume ; entorhinal cortex volume measures 3,066 mm³, 22.8% below the reference mean. With a Z-score of -1.49 (6.8th percentile), this represents mild atrophy; fusiform gyrus volume measures 14,257 mm³, 21.1% below the reference mean. With a Z-score of -1.83 (3.4th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 15,157 mm³, 24.9% below the reference mean. With a Z-score of -2.23 (1.3th percentile), this represents significant atrophy. ",
  "text_data": "Age is 89.8 years. Gender is Male. Education: 16 years. MMSE: 24.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in the hippocampus and middle temporal gyrus, along with moderate atrophy in the fusiform gyrus and mild atrophy in the entorhinal cortex—key regions affected in Alzheimer's disease. The MMSE score of 24 suggests mild cognitive impairment, and the absence of APOE4 does not rule out AD given the structural changes.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**  \n\n*(Rationale: The pattern of atrophy aligns with AD neuroanatomy, and the MMSE supports functional decline. Age is a strong risk factor, and while APOE4-negative, structural biomarkers take precedence.)*",
  "timestamp": "2025-07-25T23:20:15.850328"
}