{
  "ptid_time": "114_S_0173_2007-02-27",
  "img_path": "/data/qiuhui/data/adni/images/114_S_0173/2007-02-27/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 52,822 mm³, 37.1% above the reference mean. With a Z-score of 0.89 (81.3th percentile), this represents normal volume ; hippocampal volume measures 6,628 mm³, 12.3% below the reference mean. With a Z-score of -1.20 (11.5th percentile), this represents mild atrophy; whole brain volume measures 1,044,260 mm³, 3.3% below the reference mean. With a Z-score of -0.42 (33.6th percentile), this represents normal volume ; entorhinal cortex volume measures 3,134 mm³, 23.6% below the reference mean. With a Z-score of -1.60 (5.5th percentile), this represents moderate atrophy; fusiform gyrus volume measures 16,930 mm³, 10.1% below the reference mean. With a Z-score of -0.86 (19.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 23,495 mm³, 10.1% above the reference mean. With a Z-score of 0.91 (81.8th percentile), this represents normal volume . ",
  "text_data": "Age is 74.2 years. Gender is Male. Education: 18 years. MMSE: 30.0. Logical Memory: 10.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 1042.00 pg/mL (normal ); Total tau: 323.90 pg/mL (mild elevated); Phosphorylated tau: 30.94 pg/mL (mild elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal and entorhinal cortex volumes show mild to moderate atrophy, which are key regions affected in Alzheimer's disease. However, MMSE is normal (30/30), Aβ is normal, and other brain regions are largely within normal ranges, suggesting no significant cognitive impairment at this stage. The mild elevation in T-tau and P-tau may indicate early neurodegenerative changes but not yet meeting criteria for dementia.  \n\n**Diagnosis:** Mild Cognitive Impairment (MCI)  \n**Confidence:** Medium (due to conflicting biomarkers—normal Aβ but elevated tau, and structural atrophy in memory-related regions without clinical symptoms)",
  "timestamp": "2025-07-26T11:38:13.361011"
}