{
  "ptid_time": "022_S_0961_2008-11-18",
  "img_path": "/data/qiuhui/data/adni/images/022_S_0961/2008-11-18/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 83,943 mm³, 117.9% above the reference mean. With a Z-score of 2.83 (99.8th percentile), this represents significant enlargement; hippocampal volume measures 6,527 mm³, 13.7% below the reference mean. With a Z-score of -1.33 (9.1th percentile), this represents mild atrophy; whole brain volume measures 1,121,050 mm³, 3.9% above the reference mean. With a Z-score of 0.50 (69.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,307 mm³, 19.4% below the reference mean. With a Z-score of -1.31 (9.5th percentile), this represents mild atrophy; fusiform gyrus volume measures 11,580 mm³, 38.5% below the reference mean. With a Z-score of -3.28 (0.1th percentile), this represents profound atrophy; middle temporal gyrus volume measures 15,363 mm³, 28.0% below the reference mean. With a Z-score of -2.52 (0.6th percentile), this represents significant atrophy. ",
  "text_data": "Age is 74.8 years. Gender is Male. Education: 16 years. MMSE: 23.0. Logical Memory: 5.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 321.10 pg/mL (moderate reduced); Total tau: 537.10 pg/mL (profound elevated); Phosphorylated tau: 54.47 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in key Alzheimer's-related regions (fusiform gyrus, middle temporal gyrus, entorhinal cortex, and mild hippocampal atrophy), along with elevated ventricular volume (indicating brain shrinkage). The biomarkers (Aβ reduction, elevated T-tau and P-tau) strongly support Alzheimer's pathology. The MMSE score of 23 is consistent with mild cognitive impairment or early dementia.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**",
  "timestamp": "2025-07-26T02:08:06.565516"
}