{
  "ptid_time": "031_S_4947_2013-10-17",
  "img_path": "/data/qiuhui/data/adni/images/031_S_4947/2013-10-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 32,109 mm³, 16.6% below the reference mean. With a Z-score of -0.40 (34.5th percentile), this represents normal volume ; hippocampal volume measures 6,610 mm³, 12.6% below the reference mean. With a Z-score of -1.22 (11.0th percentile), this represents mild atrophy; whole brain volume measures 1,042,160 mm³, 3.5% below the reference mean. With a Z-score of -0.45 (32.7th percentile), this represents normal volume ; entorhinal cortex volume measures 3,420 mm³, 16.6% below the reference mean. With a Z-score of -1.13 (13.0th percentile), this represents mild atrophy; fusiform gyrus volume measures 18,312 mm³, 2.8% below the reference mean. With a Z-score of -0.24 (40.6th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,758 mm³, 7.4% below the reference mean. With a Z-score of -0.67 (25.3th percentile), this represents normal volume . ",
  "text_data": "Age is 75.5 years. Gender is Male. Education: 14 years. MMSE: 26.0. MoCA: 22.0. Logical Memory: 6.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 581.30 pg/mL (mild reduced); Total tau: 297.90 pg/mL (normal ); Phosphorylated tau: 33.13 pg/mL (moderate elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "Reasoning: The hippocampal and entorhinal cortex volumes show mild atrophy (Z-scores -1.22 and -1.13, respectively), which are key regions affected in early Alzheimer's disease. The MMSE (26) and MoCA (22) scores suggest mild cognitive impairment, and the presence of APOE4 and moderately elevated P-tau further support an Alzheimer's-like pathology.  \n\nDiagnosis: **MCI (likely due to Alzheimer's disease)**  \nConfidence: **Medium** (clinical and biomarker data align with MCI, but additional longitudinal or CSF/amyloid-PET confirmation could strengthen certainty).",
  "timestamp": "2025-07-26T04:51:20.325381"
}