{
  "ptid_time": "126_S_0891_2006-09-25",
  "img_path": "/data/qiuhui/data/adni/images/126_S_0891/2006-09-25/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 52,359 mm³, 86.5% above the reference mean. With a Z-score of 1.98 (97.6th percentile), this represents moderate enlargement; hippocampal volume measures 6,093 mm³, 14.4% below the reference mean. With a Z-score of -1.32 (9.4th percentile), this represents mild atrophy; whole brain volume measures 896,901 mm³, 8.0% below the reference mean. With a Z-score of -1.00 (15.8th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,564 mm³, 30.2% below the reference mean. With a Z-score of -1.85 (3.2th percentile), this represents moderate atrophy; fusiform gyrus volume measures 10,800 mm³, 36.5% below the reference mean. With a Z-score of -3.32 (0.0th percentile), this represents profound atrophy; middle temporal gyrus volume measures 14,103 mm³, 26.4% below the reference mean. With a Z-score of -2.29 (1.1th percentile), this represents significant atrophy. ",
  "text_data": "Age is 79.3 years. Gender is Female. Education: 12 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Major Surgical Procedures. MMSE: 22.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 680.80 pg/mL (normal ); Total tau: 224.00 pg/mL (normal ); Phosphorylated tau: 22.49 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in key Alzheimer's-related regions (hippocampus, entorhinal cortex, fusiform gyrus, middle temporal gyrus) alongside ventricular enlargement, suggesting neurodegeneration. However, normal CSF biomarkers (Aβ, T-tau, P-tau) and an MMSE of 22 (borderline impaired) complicate the picture, as these findings are atypical for typical Alzheimer’s pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely non-amnestic or non-AD subtype given biomarker profile)  \n**Confidence:** **Medium** (due to discordance between structural atrophy and normal biomarkers; other neurodegenerative or vascular etologies should be considered).",
  "timestamp": "2025-07-26T12:41:23.919362"
}