{
  "ptid_time": "023_S_1247_2007-02-21",
  "img_path": "/data/qiuhui/data/adni/images/023_S_1247/2007-02-21/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 40,800 mm³, 45.4% above the reference mean. With a Z-score of 1.04 (85.1th percentile), this represents mild enlargement; hippocampal volume measures 5,702 mm³, 19.9% below the reference mean. With a Z-score of -1.82 (3.4th percentile), this represents moderate atrophy; whole brain volume measures 915,118 mm³, 6.1% below the reference mean. With a Z-score of -0.77 (22.1th percentile), this represents normal volume ; entorhinal cortex volume measures 3,339 mm³, 9.1% below the reference mean. With a Z-score of -0.56 (28.8th percentile), this represents normal volume ; fusiform gyrus volume measures 14,543 mm³, 14.5% below the reference mean. With a Z-score of -1.32 (9.3th percentile), this represents mild atrophy; middle temporal gyrus volume measures 16,465 mm³, 14.1% below the reference mean. With a Z-score of -1.22 (11.0th percentile), this represents mild atrophy. ",
  "text_data": "Age is 72.5 years. Gender is Female. Education: 9 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Cardiovascular; Musculoskeletal; Smoking; Major Surgical Procedures. MMSE: 24.0. Logical Memory: 3.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 649.10 pg/mL (normal ); Total tau: 332.50 pg/mL (mild elevated); Phosphorylated tau: 31.94 pg/mL (mild elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows moderate hippocampal atrophy (Z-score -1.82, 3.4th percentile) and mild atrophy in the fusiform gyrus and middle temporal gyrus, alongside mild ventricular enlargement. The MMSE score of 24 suggests mild cognitive impairment, and while Aβ is normal, the mild elevations in T-tau and P-tau may indicate early neurodegenerative changes.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting biomarkers—normal Aβ but elevated tau—and structural changes consistent with early neurodegeneration)",
  "timestamp": "2025-07-26T02:56:45.965756"
}