{
  "ptid_time": "133_S_0525_2007-07-26",
  "img_path": "/data/qiuhui/data/adni/images/133_S_0525/2007-07-26/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 46,054 mm³, 64.1% above the reference mean. With a Z-score of 1.47 (92.9th percentile), this represents mild enlargement; hippocampal volume measures 6,103 mm³, 14.2% below the reference mean. With a Z-score of -1.30 (9.6th percentile), this represents mild atrophy; whole brain volume measures 869,921 mm³, 10.7% below the reference mean. With a Z-score of -1.35 (8.8th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,781 mm³, 2.9% above the reference mean. With a Z-score of 0.18 (57.2th percentile), this represents normal volume ; fusiform gyrus volume measures 12,965 mm³, 23.8% below the reference mean. With a Z-score of -2.17 (1.5th percentile), this represents significant atrophy; middle temporal gyrus volume measures 14,719 mm³, 23.2% below the reference mean. With a Z-score of -2.02 (2.2th percentile), this represents significant atrophy. ",
  "text_data": "Age is 71.0 years. Gender is Female. Education: 16 years. MMSE: 30.0. Logical Memory: 17.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 618.10 pg/mL (mild reduced); Total tau: 177.70 pg/mL (normal ); Phosphorylated tau: 17.64 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the fusiform gyrus and middle temporal gyrus, along with mild hippocampal and whole-brain atrophy, which are concerning for neurodegenerative changes. However, the MMSE score of 30 is normal, and CSF biomarkers (Aβ mildly reduced, T-tau and P-tau normal) do not strongly support Alzheimer’s pathology.  \n**Diagnosis:** **MCI** (due to structural atrophy despite normal cognition, possibly early neurodegenerative changes)  \n**Confidence:** **Medium** (conflicting findings—imaging suggests neurodegeneration, but cognitive and biomarker data are not strongly supportive of dementia)",
  "timestamp": "2025-07-26T15:21:23.214294"
}