{
  "ptid_time": "022_S_1097_2009-12-08",
  "img_path": "/data/qiuhui/data/adni/images/022_S_1097/2009-12-08/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 35,068 mm³, 9.0% below the reference mean. With a Z-score of -0.21 (41.5th percentile), this represents normal volume ; hippocampal volume measures 5,039 mm³, 33.3% below the reference mean. With a Z-score of -3.25 (0.1th percentile), this represents profound atrophy; whole brain volume measures 948,176 mm³, 12.2% below the reference mean. With a Z-score of -1.58 (5.7th percentile), this represents moderate atrophy; entorhinal cortex volume measures 2,710 mm³, 33.9% below the reference mean. With a Z-score of -2.30 (1.1th percentile), this represents significant atrophy; fusiform gyrus volume measures 15,806 mm³, 16.1% below the reference mean. With a Z-score of -1.37 (8.5th percentile), this represents mild atrophy; middle temporal gyrus volume measures 17,707 mm³, 17.0% below the reference mean. With a Z-score of -1.53 (6.3th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 76.0 years. Gender is Male. Education: 18 years. MMSE: 23.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 720.90 pg/mL (normal ); Total tau: 553.90 pg/mL (profound elevated); Phosphorylated tau: 58.55 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound hippocampal atrophy (Z-score -3.25) and significant entorhinal cortex atrophy (Z-score -2.30), which are strongly associated with Alzheimer's pathology. The MMSE score of 23 suggests mild cognitive impairment, and the biomarker profile (normal Aβ but profoundly elevated T-tau and P-tau) is consistent with Alzheimer's disease despite the absence of APOE4.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**",
  "timestamp": "2025-07-26T02:09:06.687219"
}