{
  "ptid_time": "027_S_0835_2008-09-23",
  "img_path": "/data/qiuhui/data/adni/images/027_S_0835/2008-09-23/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 37,039 mm³, 3.8% below the reference mean. With a Z-score of -0.09 (46.3th percentile), this represents normal volume ; hippocampal volume measures 5,756 mm³, 23.9% below the reference mean. With a Z-score of -2.33 (1.0th percentile), this represents significant atrophy; whole brain volume measures 1,095,360 mm³, 1.5% above the reference mean. With a Z-score of 0.19 (57.6th percentile), this represents normal volume ; entorhinal cortex volume measures 3,145 mm³, 23.3% below the reference mean. With a Z-score of -1.58 (5.7th percentile), this represents moderate atrophy; fusiform gyrus volume measures 16,170 mm³, 14.2% below the reference mean. With a Z-score of -1.21 (11.4th percentile), this represents mild atrophy; middle temporal gyrus volume measures 18,884 mm³, 11.5% below the reference mean. With a Z-score of -1.03 (15.1th percentile), this represents mild atrophy. ",
  "text_data": "Age is 74.7 years. Gender is Male. Education: 14 years. MMSE: 21.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 555.60 pg/mL (mild reduced); Total tau: 315.40 pg/mL (normal ); Phosphorylated tau: 30.91 pg/mL (mild elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant hippocampal atrophy (Z-score -2.33, 1st percentile) and moderate entorhinal cortex atrophy (Z-score -1.58, 5.7th percentile), both key regions in Alzheimer's pathology. The MMSE score of 21 suggests cognitive impairment, and the presence of APOE4 along with mildly reduced Aβ and elevated P-tau supports an Alzheimer's-like biomarker profile.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**",
  "timestamp": "2025-07-26T03:42:40.722215"
}