{
  "ptid_time": "133_S_1055_2006-11-13",
  "img_path": "/data/qiuhui/data/adni/images/133_S_1055/2006-11-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 56,323 mm³, 19.8% above the reference mean. With a Z-score of 0.57 (71.7th percentile), this represents normal volume ; hippocampal volume measures 5,521 mm³, 20.8% below the reference mean. With a Z-score of -1.79 (3.6th percentile), this represents moderate atrophy; whole brain volume measures 865,515 mm³, 15.9% below the reference mean. With a Z-score of -2.08 (1.9th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,427 mm³, 38.9% below the reference mean. With a Z-score of -2.54 (0.5th percentile), this represents significant atrophy; fusiform gyrus volume measures 11,931 mm³, 34.0% below the reference mean. With a Z-score of -2.94 (0.2th percentile), this represents significant atrophy; middle temporal gyrus volume measures 12,364 mm³, 38.7% below the reference mean. With a Z-score of -3.47 (0.0th percentile), this represents profound atrophy. ",
  "text_data": "Age is 84.6 years. Gender is Male. Education: 15 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking; Malignancy; Major Surgical Procedures. MMSE: 21.0. Logical Memory: 1.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 494.60 pg/mL (mild reduced); Total tau: 383.90 pg/mL (moderate elevated); Phosphorylated tau: 38.42 pg/mL (significant elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in multiple brain regions, including the hippocampus, entorhinal cortex, fusiform gyrus, and middle temporal gyrus, all of which are strongly associated with Alzheimer's pathology. The MMSE score of 21, along with elevated P-tau and T-tau levels and mildly reduced Aβ, further supports a neurodegenerative process consistent with Alzheimer's disease.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease)  \n**Confidence:** **High**",
  "timestamp": "2025-07-26T15:30:12.297647"
}