{
  "ptid_time": "022_S_1097_2007-12-12",
  "img_path": "/data/qiuhui/data/adni/images/022_S_1097/2007-12-12/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 30,655 mm³, 20.4% below the reference mean. With a Z-score of -0.49 (31.2th percentile), this represents normal volume ; hippocampal volume measures 5,714 mm³, 24.4% below the reference mean. With a Z-score of -2.38 (0.9th percentile), this represents significant atrophy; whole brain volume measures 970,842 mm³, 10.1% below the reference mean. With a Z-score of -1.31 (9.6th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,039 mm³, 25.9% below the reference mean. With a Z-score of -1.76 (4.0th percentile), this represents moderate atrophy; fusiform gyrus volume measures 16,213 mm³, 13.9% below the reference mean. With a Z-score of -1.19 (11.8th percentile), this represents mild atrophy; middle temporal gyrus volume measures 18,601 mm³, 12.8% below the reference mean. With a Z-score of -1.15 (12.4th percentile), this represents mild atrophy. ",
  "text_data": "Age is 74.0 years. Gender is Male. Education: 18 years. MMSE: 23.0. Logical Memory: 2.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 687.50 pg/mL (normal ); Total tau: 482.70 pg/mL (profound elevated); Phosphorylated tau: 51.64 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant hippocampal atrophy (Z-score -2.38) and moderate entorhinal cortex atrophy, both strongly associated with Alzheimer's pathology. Elevated T-tau and P-tau with normal Aβ suggest non-amyloid neurodegeneration (e.g., primary tauopathy or PART). The MMSE of 23 indicates cognitive impairment, but the absence of APOE4 and normal Aβ complicates a typical AD diagnosis.  \n\n**Diagnosis:** **Dementia** (likely non-AD tauopathy or PART)  \n**Confidence:** **Medium** (atypical biomarker profile but clear structural/functional decline)",
  "timestamp": "2025-07-26T02:08:28.670276"
}