{
  "ptid_time": "099_S_0470_2007-05-17",
  "img_path": "/data/qiuhui/data/adni/images/099_S_0470/2007-05-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 29,442 mm³, 20.4% below the reference mean. With a Z-score of -0.55 (29.1th percentile), this represents normal volume ; hippocampal volume measures 5,367 mm³, 17.4% below the reference mean. With a Z-score of -1.39 (8.2th percentile), this represents mild atrophy; whole brain volume measures 925,913 mm³, 0.2% below the reference mean. With a Z-score of -0.03 (48.8th percentile), this represents normal volume ; entorhinal cortex volume measures 1,810 mm³, 47.7% below the reference mean. With a Z-score of -2.58 (0.5th percentile), this represents significant atrophy; fusiform gyrus volume measures 13,843 mm³, 14.1% below the reference mean. With a Z-score of -1.06 (14.5th percentile), this represents mild atrophy; middle temporal gyrus volume measures 15,299 mm³, 15.1% below the reference mean. With a Z-score of -1.35 (8.9th percentile), this represents mild atrophy. ",
  "text_data": "Age is 87.6 years. Gender is Female. Education: 13 years. MMSE: 20.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 618.30 pg/mL (mild reduced); Total tau: 443.80 pg/mL (significant elevated); Phosphorylated tau: 44.08 pg/mL (significant elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the entorhinal cortex (Z-score -2.58, 0.5th percentile) and mild atrophy in the hippocampus (Z-score -1.39, 8.2th percentile), fusiform gyrus, and middle temporal gyrus—all regions heavily implicated in Alzheimer's disease. The CSF biomarkers (elevated T-tau and P-tau, mildly reduced Aβ) further support AD pathology. The MMSE score of 20 (moderate impairment) aligns with cognitive decline.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**",
  "timestamp": "2025-07-26T10:56:37.194070"
}