{
  "ptid_time": "057_S_0941_2007-10-31",
  "img_path": "/data/qiuhui/data/adni/images/057_S_0941/2007-10-31/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 70,414 mm³, 150.9% above the reference mean. With a Z-score of 3.45 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 5,542 mm³, 22.1% below the reference mean. With a Z-score of -2.03 (2.1th percentile), this represents significant atrophy; whole brain volume measures 951,628 mm³, 2.4% below the reference mean. With a Z-score of -0.30 (38.3th percentile), this represents normal volume ; entorhinal cortex volume measures 3,707 mm³, 0.9% above the reference mean. With a Z-score of 0.06 (52.3th percentile), this represents normal volume ; fusiform gyrus volume measures 12,955 mm³, 23.9% below the reference mean. With a Z-score of -2.17 (1.5th percentile), this represents significant atrophy; middle temporal gyrus volume measures 14,786 mm³, 22.9% below the reference mean. With a Z-score of -1.99 (2.4th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 74.3 years. Gender is Female. Education: 14 years. MMSE: 18.0. Logical Memory: 1.0. APOEε4 alleles: 2.0. Biomarker levels: Amyloid beta: 481.80 pg/mL (mild reduced); Total tau: 299.50 pg/mL (normal ); Phosphorylated tau: 26.32 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound ventricular enlargement and significant atrophy in the hippocampus, fusiform gyrus, and middle temporal gyrus—key regions affected in Alzheimer's disease. The MMSE score of 18 indicates significant cognitive impairment, and the presence of two APOE4 alleles increases Alzheimer's risk, though CSF biomarkers (Aβ mildly reduced, normal tau) are not strongly supportive.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease, though atypical biomarker profile).  \n**Confidence:** **Medium** (due to conflicting imaging and biomarker data).",
  "timestamp": "2025-07-26T08:07:31.287214"
}