{
  "ptid_time": "128_S_0266_2006-10-03",
  "img_path": "/data/qiuhui/data/adni/images/128_S_0266/2006-10-03/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 90,175 mm³, 91.8% above the reference mean. With a Z-score of 2.67 (99.6th percentile), this represents significant enlargement; hippocampal volume measures 5,396 mm³, 22.6% below the reference mean. With a Z-score of -1.95 (2.6th percentile), this represents moderate atrophy; whole brain volume measures 1,012,720 mm³, 1.6% below the reference mean. With a Z-score of -0.21 (41.7th percentile), this represents normal volume ; entorhinal cortex volume measures 2,743 mm³, 30.9% below the reference mean. With a Z-score of -2.02 (2.2th percentile), this represents significant atrophy; fusiform gyrus volume measures 15,574 mm³, 13.8% below the reference mean. With a Z-score of -1.19 (11.6th percentile), this represents mild atrophy; middle temporal gyrus volume measures 16,487 mm³, 18.3% below the reference mean. With a Z-score of -1.64 (5.1th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 86.0 years. Gender is Male. Education: 20 years. MMSE: 26.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (Z-score 2.67) and moderate-to-severe atrophy in key Alzheimer’s-related regions (hippocampus, entorhinal cortex, middle temporal gyrus). The MMSE score of 26 is borderline, but the structural changes, particularly in the hippocampus and entorhinal cortex, strongly suggest neurodegeneration. The presence of one APOE4 allele further supports Alzheimer’s pathology.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease)  \n**Confidence:** **High**",
  "timestamp": "2025-07-26T13:43:17.839763"
}