{
  "ptid_time": "035_S_0292_2007-05-10",
  "img_path": "/data/qiuhui/data/adni/images/035_S_0292/2007-05-10/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 45,104 mm³, 17.1% above the reference mean. With a Z-score of 0.41 (65.9th percentile), this represents normal volume ; hippocampal volume measures 5,252 mm³, 30.5% below the reference mean. With a Z-score of -2.98 (0.1th percentile), this represents significant atrophy; whole brain volume measures 1,037,590 mm³, 3.9% below the reference mean. With a Z-score of -0.50 (30.8th percentile), this represents normal volume ; entorhinal cortex volume measures 2,998 mm³, 26.9% below the reference mean. With a Z-score of -1.82 (3.4th percentile), this represents moderate atrophy; fusiform gyrus volume measures 17,194 mm³, 8.7% below the reference mean. With a Z-score of -0.74 (22.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,984 mm³, 15.7% below the reference mean. With a Z-score of -1.41 (7.9th percentile), this represents mild atrophy. ",
  "text_data": "Age is 77.4 years. Gender is Male. Education: 16 years. MMSE: 23.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 809.80 pg/mL (normal ); Total tau: 136.80 pg/mL (mild reduced); Phosphorylated tau: 11.97 pg/mL (mild reduced). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant hippocampal atrophy (Z-score -2.98, 0.1th percentile) and moderate entorhinal cortex atrophy (Z-score -1.82, 3.4th percentile), both key regions affected in Alzheimer's disease. The MMSE score of 23 suggests cognitive impairment, but normal Aβ levels and reduced tau biomarkers are atypical for AD, possibly indicating another neurodegenerative process or non-AD pathology.  \n\n**Diagnosis:** **MCI** (given cognitive decline and structural atrophy but conflicting biomarker profile)  \n**Confidence:** **Medium** (due to biomarker inconsistency with typical AD patterns)",
  "timestamp": "2025-07-26T05:45:50.364020"
}