{
  "ptid_time": "023_S_0331_2007-03-19",
  "img_path": "/data/qiuhui/data/adni/images/023_S_0331/2007-03-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 30,298 mm³, 35.6% above the reference mean. With a Z-score of 0.89 (81.4th percentile), this represents normal volume ; hippocampal volume measures 5,264 mm³, 31.5% below the reference mean. With a Z-score of -3.53 (0.0th percentile), this represents profound atrophy; whole brain volume measures 965,843 mm³, 6.2% below the reference mean. With a Z-score of -0.77 (22.2th percentile), this represents normal volume ; entorhinal cortex volume measures 2,514 mm³, 35.4% below the reference mean. With a Z-score of -2.74 (0.3th percentile), this represents significant atrophy; fusiform gyrus volume measures 15,333 mm³, 15.8% below the reference mean. With a Z-score of -1.78 (3.8th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 17,032 mm³, 17.0% below the reference mean. With a Z-score of -1.51 (6.5th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 65.6 years. Gender is Female. Education: 14 years. MMSE: 24.0. Logical Memory: 0.0. APOEε4 alleles: 2.0. Biomarker levels: Amyloid beta: 585.30 pg/mL (mild reduced); Total tau: 381.50 pg/mL (moderate elevated); Phosphorylated tau: 37.75 pg/mL (significant elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound hippocampal atrophy (Z-score -3.53) and significant entorhinal cortex atrophy (Z-score -2.74), both strongly associated with Alzheimer's pathology. Moderate atrophy in the fusiform gyrus and middle temporal gyrus, along with elevated P-tau and T-tau, further support neurodegeneration. The MMSE score of 24 suggests mild cognitive impairment, consistent with the biomarker and structural findings.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**",
  "timestamp": "2025-07-26T02:40:10.713801"
}