{
  "ptid_time": "023_S_0084_2008-01-22",
  "img_path": "/data/qiuhui/data/adni/images/023_S_0084/2008-01-22/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 34,341 mm³, 22.3% above the reference mean. With a Z-score of 0.51 (69.6th percentile), this represents normal volume ; hippocampal volume measures 3,998 mm³, 43.8% below the reference mean. With a Z-score of -4.02 (0.0th percentile), this represents profound atrophy; whole brain volume measures 838,195 mm³, 14.0% below the reference mean. With a Z-score of -1.76 (3.9th percentile), this represents moderate atrophy; entorhinal cortex volume measures 2,016 mm³, 45.1% below the reference mean. With a Z-score of -2.77 (0.3th percentile), this represents significant atrophy; fusiform gyrus volume measures 12,302 mm³, 27.7% below the reference mean. With a Z-score of -2.52 (0.6th percentile), this represents significant atrophy; middle temporal gyrus volume measures 15,591 mm³, 18.7% below the reference mean. With a Z-score of -1.62 (5.3th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 77.3 years. Gender is Female. Education: 14 years. MMSE: 28.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 386.50 pg/mL (moderate reduced); Total tau: 305.90 pg/mL (normal ); Phosphorylated tau: 30.69 pg/mL (mild elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows profound hippocampal atrophy (Z-score -4.02) and significant atrophy in the entorhinal cortex and fusiform gyrus, which are hallmark features of Alzheimer's disease. Despite a high MMSE score (28/30), the structural changes and biomarker profile (moderately reduced Aβ and mildly elevated p-tau) strongly suggest neurodegenerative pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI) due to Alzheimer’s disease**  \n**Confidence:** **High**  \n\n*(Note: The MMSE is relatively preserved, but the degree of atrophy and biomarker abnormalities indicate early-stage Alzheimer’s pathology. The diagnosis would likely progress to dementia over time.)*",
  "timestamp": "2025-07-26T02:35:41.024029"
}