{
  "ptid_time": "002_S_0295_2007-05-25",
  "img_path": "/data/qiuhui/data/adni/images/002_S_0295/2007-05-25/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 40,554 mm³, 13.7% below the reference mean. With a Z-score of -0.40 (34.5th percentile), this represents normal volume ; hippocampal volume measures 6,894 mm³, 1.1% below the reference mean. With a Z-score of -0.09 (46.3th percentile), this represents normal volume ; whole brain volume measures 1,085,210 mm³, 5.4% above the reference mean. With a Z-score of 0.71 (76.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,572 mm³, 10.0% below the reference mean. With a Z-score of -0.65 (25.6th percentile), this represents normal volume ; fusiform gyrus volume measures 17,386 mm³, 3.8% below the reference mean. With a Z-score of -0.33 (37.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,917 mm³, 1.3% below the reference mean. With a Z-score of -0.11 (45.5th percentile), this represents normal volume . ",
  "text_data": "Age is 85.8 years. Gender is Male. Education: 18 years. MMSE: 30.0. Logical Memory: 15.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 858.30 pg/mL (normal ); Total tau: 399.50 pg/mL (significant elevated); Phosphorylated tau: 39.29 pg/mL (significant elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volumes (ventricular, hippocampal, whole brain, entorhinal cortex, fusiform gyrus, and middle temporal gyrus) are all within normal ranges based on Z-scores and percentiles. However, the CSF biomarkers show a significant elevation in T-tau and P-tau, which is suggestive of neurodegeneration, despite normal Aβ levels. The MMSE score of 30 is intact, indicating no significant cognitive impairment.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (biomarker evidence of neurodegeneration without significant cognitive decline)  \n**Confidence:** **Medium** (due to conflicting biomarkers—normal Aβ but elevated tau—and intact MMSE, suggesting early-stage changes)",
  "timestamp": "2025-07-25T19:59:51.030403"
}