{
  "ptid_time": "033_S_1098_2009-12-02",
  "img_path": "/data/qiuhui/data/adni/images/033_S_1098/2009-12-02/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 20,698 mm³, 26.3% below the reference mean. With a Z-score of -0.60 (27.4th percentile), this represents normal volume ; hippocampal volume measures 6,439 mm³, 9.5% below the reference mean. With a Z-score of -0.87 (19.2th percentile), this represents normal volume ; whole brain volume measures 876,569 mm³, 10.1% below the reference mean. With a Z-score of -1.27 (10.3th percentile), this represents mild atrophy; entorhinal cortex volume measures 4,423 mm³, 20.4% above the reference mean. With a Z-score of 1.25 (89.5th percentile), this represents mild enlargement; fusiform gyrus volume measures 14,928 mm³, 12.3% below the reference mean. With a Z-score of -1.12 (13.2th percentile), this represents mild atrophy; middle temporal gyrus volume measures 17,979 mm³, 6.2% below the reference mean. With a Z-score of -0.54 (29.5th percentile), this represents normal volume . ",
  "text_data": "Age is 75.0 years. Gender is Female. Education: 15 years. MMSE: 30.0. Logical Memory: 21.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 540.40 pg/mL (mild reduced); Total tau: 421.90 pg/mL (significant elevated); Phosphorylated tau: 46.83 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The patient shows mild atrophy in whole brain and fusiform gyrus volumes, along with elevated tau biomarkers (T-tau and P-tau), suggesting early neurodegenerative changes. However, hippocampal volume is normal, MMSE is intact (30/30), and Aβ is only mildly reduced, which argues against advanced pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Biomarkers and some atrophy suggest early neurodegeneration, but preserved cognition and normal hippocampal volume make dementia less likely at this stage.)",
  "timestamp": "2025-07-26T05:29:05.764380"
}