{
  "ptid_time": "033_S_0906_2007-10-01",
  "img_path": "/data/qiuhui/data/adni/images/033_S_0906/2007-10-01/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 19,182 mm³, 14.1% below the reference mean. With a Z-score of -0.35 (36.2th percentile), this represents normal volume ; hippocampal volume measures 6,502 mm³, 15.4% below the reference mean. With a Z-score of -1.73 (4.2th percentile), this represents moderate atrophy; whole brain volume measures 968,786 mm³, 5.9% below the reference mean. With a Z-score of -0.73 (23.3th percentile), this represents normal volume ; entorhinal cortex volume measures 2,561 mm³, 34.2% below the reference mean. With a Z-score of -2.65 (0.4th percentile), this represents significant atrophy; fusiform gyrus volume measures 16,834 mm³, 7.6% below the reference mean. With a Z-score of -0.85 (19.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,756 mm³, 18.3% below the reference mean. With a Z-score of -1.63 (5.2th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 66.3 years. Gender is Female. Education: 12 years. MMSE: 25.0. Logical Memory: 1.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 760.60 pg/mL (normal ); Total tau: 356.50 pg/mL (mild elevated); Phosphorylated tau: 34.78 pg/mL (moderate elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal and entorhinal cortex volumes show moderate to significant atrophy (Z-scores of -1.73 and -2.65, respectively), which are key regions affected in Alzheimer's disease. The MMSE score of 25 is borderline, and the CSF biomarkers (normal Aβ but elevated T-tau and P-tau) suggest Alzheimer's pathology despite normal amyloid levels.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer's pathology)  \n**Confidence:** **Medium** (due to conflicting Aβ and tau findings, but strong structural atrophy in AD-vulnerable regions)",
  "timestamp": "2025-07-26T05:21:08.711324"
}