{
  "ptid_time": "023_S_0084_2007-01-24",
  "img_path": "/data/qiuhui/data/adni/images/023_S_0084/2007-01-24/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 32,768 mm³, 16.7% above the reference mean. With a Z-score of 0.38 (64.9th percentile), this represents normal volume ; hippocampal volume measures 4,185 mm³, 41.2% below the reference mean. With a Z-score of -3.78 (0.0th percentile), this represents profound atrophy; whole brain volume measures 850,272 mm³, 12.8% below the reference mean. With a Z-score of -1.61 (5.4th percentile), this represents moderate atrophy; entorhinal cortex volume measures 1,897 mm³, 48.4% below the reference mean. With a Z-score of -2.97 (0.1th percentile), this represents significant atrophy; fusiform gyrus volume measures 12,621 mm³, 25.8% below the reference mean. With a Z-score of -2.35 (0.9th percentile), this represents significant atrophy; middle temporal gyrus volume measures 15,832 mm³, 17.4% below the reference mean. With a Z-score of -1.51 (6.5th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 76.3 years. Gender is Female. Education: 14 years. MMSE: 25.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 528.20 pg/mL (mild reduced); Total tau: 290.80 pg/mL (normal ); Phosphorylated tau: 30.79 pg/mL (mild elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound hippocampal atrophy (Z-score -3.78), significant entorhinal cortex and fusiform gyrus atrophy, and moderate whole brain and middle temporal gyrus atrophy, all of which are strongly associated with Alzheimer's pathology. The MMSE score of 25 is borderline, and the presence of APOE4, mildly reduced Aβ, and mildly elevated P-tau further support an Alzheimer's-like neurodegenerative process.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**",
  "timestamp": "2025-07-26T02:35:33.165093"
}