{
  "ptid_time": "033_S_0724_2008-08-11",
  "img_path": "/data/qiuhui/data/adni/images/033_S_0724/2008-08-11/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 134,086 mm³, 185.2% above the reference mean. With a Z-score of 5.38 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 6,150 mm³, 11.7% below the reference mean. With a Z-score of -1.01 (15.5th percentile), this represents mild atrophy; whole brain volume measures 973,752 mm³, 5.4% below the reference mean. With a Z-score of -0.71 (24.0th percentile), this represents normal volume ; entorhinal cortex volume measures 4,255 mm³, 7.2% above the reference mean. With a Z-score of 0.47 (68.1th percentile), this represents normal volume ; fusiform gyrus volume measures 13,105 mm³, 27.5% below the reference mean. With a Z-score of -2.38 (0.9th percentile), this represents significant atrophy; middle temporal gyrus volume measures 10,988 mm³, 45.5% below the reference mean. With a Z-score of -4.08 (0.0th percentile), this represents profound atrophy. ",
  "text_data": "Age is 80.6 years. Gender is Male. Education: 20 years. MMSE: 6.0. Logical Memory: 1.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 796.50 pg/mL (normal ); Total tau: 349.30 pg/mL (mild elevated); Phosphorylated tau: 33.95 pg/mL (moderate elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows profound ventricular enlargement and significant atrophy in the fusiform gyrus and middle temporal gyrus, alongside mild hippocampal atrophy. The MMSE score of 6.0 indicates severe cognitive impairment, and the elevated T-tau and P-tau levels suggest neurodegeneration, despite normal Aβ levels (arguing against typical Alzheimer's pathology).  \n**Diagnosis:** Dementia (likely non-Alzheimer's neurodegenerative type, e.g., primary tauopathy or semantic variant primary progressive aphasia given temporal lobe atrophy).  \n**Confidence:** Medium (due to atypical biomarker profile but clear structural and functional deficits).",
  "timestamp": "2025-07-26T05:15:15.614943"
}