{
  "ptid_time": "033_S_0906_2009-10-02",
  "img_path": "/data/qiuhui/data/adni/images/033_S_0906/2009-10-02/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 27,710 mm³, 24.1% above the reference mean. With a Z-score of 0.60 (72.6th percentile), this represents normal volume ; hippocampal volume measures 5,593 mm³, 27.2% below the reference mean. With a Z-score of -3.05 (0.1th percentile), this represents profound atrophy; whole brain volume measures 912,639 mm³, 11.3% below the reference mean. With a Z-score of -1.41 (7.9th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,258 mm³, 42.0% below the reference mean. With a Z-score of -3.25 (0.1th percentile), this represents profound atrophy; fusiform gyrus volume measures 15,400 mm³, 15.4% below the reference mean. With a Z-score of -1.74 (4.1th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 13,688 mm³, 33.3% below the reference mean. With a Z-score of -2.96 (0.2th percentile), this represents significant atrophy. ",
  "text_data": "Age is 68.3 years. Gender is Female. Education: 12 years. MMSE: 24.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 840.40 pg/mL (normal ); Total tau: 410.40 pg/mL (significant elevated); Phosphorylated tau: 39.55 pg/mL (significant elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows profound atrophy in the hippocampus and entorhinal cortex, along with significant atrophy in the middle temporal gyrus—key regions affected in Alzheimer’s disease (AD). Elevated T-tau and P-tau with normal Aβ suggest a tauopathy, likely AD, despite the MMSE score of 24 (borderline impaired). The preserved ventricular volume argues against advanced global atrophy.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **Medium** (Clinical correlation needed; MMSE is borderline, but biomarker and structural data strongly support neurodegenerative disease.)  \n\n**Key points:**  \n- **Tauopathy profile** (elevated T-tau/P-tau + normal Aβ) is classic for AD.  \n- **Hippocampal/entorhinal atrophy** is severe and specific to AD.  \n- **MMSE 24** could reflect early dementia or MCI, but structural damage is advanced.  \n- Confidence isn’t \"High\" due to lack of functional decline documentation (e.g., ADLs).  \n\nAlternative consideration: **MCI due to AD** if symptoms are mild, but atrophy severity leans toward dementia.",
  "timestamp": "2025-07-26T05:21:39.570592"
}