{
  "ptid_time": "021_S_0424_2010-05-07",
  "img_path": "/data/qiuhui/data/adni/images/021_S_0424/2010-05-07/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 68,535 mm³, 45.8% above the reference mean. With a Z-score of 1.33 (90.8th percentile), this represents mild enlargement; hippocampal volume measures 5,716 mm³, 18.0% below the reference mean. With a Z-score of -1.55 (6.0th percentile), this represents moderate atrophy; whole brain volume measures 874,284 mm³, 15.0% below the reference mean. With a Z-score of -1.97 (2.4th percentile), this represents moderate atrophy; entorhinal cortex volume measures 3,329 mm³, 16.1% below the reference mean. With a Z-score of -1.06 (14.6th percentile), this represents mild atrophy; fusiform gyrus volume measures 15,960 mm³, 11.7% below the reference mean. With a Z-score of -1.01 (15.6th percentile), this represents mild atrophy; middle temporal gyrus volume measures 16,948 mm³, 16.0% below the reference mean. With a Z-score of -1.43 (7.6th percentile), this represents mild atrophy. ",
  "text_data": "Age is 84.6 years. Gender is Male. Education: 16 years. MMSE: 23.0. Logical Memory: 6.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 456.20 pg/mL (mild reduced); Total tau: 255.40 pg/mL (normal ); Phosphorylated tau: 21.20 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows moderate hippocampal and whole brain atrophy, along with mild atrophy in other key regions (entorhinal cortex, fusiform gyrus, middle temporal gyrus), which is consistent with neurodegeneration. The MMSE score of 23 (below the typical cutoff of 24-26 for normal cognition in older adults) and mild Aβ reduction suggest early cognitive impairment, though tau markers are normal.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely amnestic subtype given hippocampal atrophy).  \n\n**Confidence:** **Medium** (strong structural evidence but normal tau levels and only mild Aβ reduction complicate a definitive Alzheimer’s diagnosis at this stage).",
  "timestamp": "2025-07-26T01:31:46.758220"
}