{
  "ptid_time": "023_S_0331_2007-04-11",
  "img_path": "/data/qiuhui/data/adni/images/023_S_0331/2007-04-11/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 30,298 mm³, 35.6% above the reference mean. With a Z-score of 0.89 (81.4th percentile), this represents normal volume ; hippocampal volume measures 5,264 mm³, 31.5% below the reference mean. With a Z-score of -3.53 (0.0th percentile), this represents profound atrophy; whole brain volume measures 965,843 mm³, 6.2% below the reference mean. With a Z-score of -0.77 (22.2th percentile), this represents normal volume ; entorhinal cortex volume measures 2,514 mm³, 35.4% below the reference mean. With a Z-score of -2.74 (0.3th percentile), this represents significant atrophy; fusiform gyrus volume measures 15,333 mm³, 15.8% below the reference mean. With a Z-score of -1.78 (3.8th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 17,032 mm³, 17.0% below the reference mean. With a Z-score of -1.51 (6.5th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 65.6 years. Gender is Female. Education: 14 years. MMSE: 24.0. Logical Memory: 0.0. APOEε4 alleles: 2.0. Biomarker levels: Amyloid beta: 585.30 pg/mL (mild reduced); Total tau: 381.50 pg/mL (moderate elevated); Phosphorylated tau: 37.75 pg/mL (significant elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows profound hippocampal atrophy (Z-score -3.53) and significant entorhinal cortex atrophy (Z-score -2.74), both strongly associated with Alzheimer’s pathology. Moderate atrophy in the fusiform gyrus and middle temporal gyrus further supports neurodegeneration. Clinically, the patient has an MMSE of 24 (mild cognitive impairment range), APOE4 homozygosity (high genetic risk), and CSF biomarkers (elevated P-tau and T-tau with reduced Aβ) consistent with Alzheimer’s disease.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**",
  "timestamp": "2025-07-26T02:40:18.426954"
}