{
  "ptid_time": "023_S_0139_2006-01-24",
  "img_path": "/data/qiuhui/data/adni/images/023_S_0139/2006-01-24/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 26,069 mm³, 16.7% above the reference mean. With a Z-score of 0.42 (66.2th percentile), this represents normal volume ; hippocampal volume measures 5,201 mm³, 32.3% below the reference mean. With a Z-score of -3.63 (0.0th percentile), this represents profound atrophy; whole brain volume measures 871,987 mm³, 15.3% below the reference mean. With a Z-score of -1.90 (2.9th percentile), this represents moderate atrophy; entorhinal cortex volume measures 3,620 mm³, 7.0% below the reference mean. With a Z-score of -0.54 (29.3th percentile), this represents normal volume ; fusiform gyrus volume measures 15,449 mm³, 15.2% below the reference mean. With a Z-score of -1.71 (4.4th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 14,015 mm³, 31.7% below the reference mean. With a Z-score of -2.82 (0.2th percentile), this represents significant atrophy. ",
  "text_data": "Age is 65.9 years. Gender is Female. Education: 13 years. Handedness: Right. Race: White. Medical history: Neurologic; Cardiovascular; Musculoskeletal; Gastrointestinal; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 25.0. Logical Memory: 0.0. APOEε4 alleles: 2.0. Biomarker levels: Amyloid beta: 651.90 pg/mL (normal ); Total tau: 395.90 pg/mL (moderate elevated); Phosphorylated tau: 45.14 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows profound hippocampal atrophy (Z-score -3.63) and significant atrophy in the middle temporal gyrus (Z-score -2.82), along with moderate whole brain and fusiform gyrus atrophy. Despite normal Aβ levels, elevated T-tau and profound P-tau suggest neurodegeneration. The MMSE of 25 is borderline, but structural changes align with Alzheimer's pathology.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**",
  "timestamp": "2025-07-26T02:37:43.911722"
}