{
  "ptid_time": "023_S_0613_2006-07-24",
  "img_path": "/data/qiuhui/data/adni/images/023_S_0613/2006-07-24/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 24,473 mm³, 33.8% below the reference mean. With a Z-score of -0.91 (18.1th percentile), this represents normal volume ; hippocampal volume measures 6,652 mm³, 2.4% above the reference mean. With a Z-score of 0.19 (57.7th percentile), this represents normal volume ; whole brain volume measures 872,590 mm³, 6.0% below the reference mean. With a Z-score of -0.72 (23.6th percentile), this represents normal volume ; entorhinal cortex volume measures 2,693 mm³, 22.2% below the reference mean. With a Z-score of -1.20 (11.5th percentile), this represents mild atrophy; fusiform gyrus volume measures 10,237 mm³, 36.5% below the reference mean. With a Z-score of -2.74 (0.3th percentile), this represents significant atrophy; middle temporal gyrus volume measures 14,407 mm³, 20.1% below the reference mean. With a Z-score of -1.79 (3.7th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 84.0 years. Gender is Female. Education: 11 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Gastrointestinal; Hematopoietic-Lymphatic; Allergies or Drug Sensitivities; Malignancy; Major Surgical Procedures. MMSE: 24.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 728.60 pg/mL (normal ); Total tau: 509.70 pg/mL (profound elevated); Phosphorylated tau: 57.13 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "Reasoning: The volumetric data shows significant atrophy in the fusiform gyrus and moderate atrophy in the middle temporal gyrus, with mild atrophy in the entorhinal cortex, while other regions (hippocampus, ventricles, whole brain) are within normal ranges. The clinical profile includes an MMSE of 24 (mild cognitive impairment range), normal Aβ but profoundly elevated T-tau and P-tau, which is suggestive of a tauopathy such as primary age-related tauopathy (PART) or atypical Alzheimer's disease.  \nDiagnosis: **MCI** (likely due to underlying tau pathology)  \nConfidence: **Medium** (due to conflicting biomarkers—normal Aβ but elevated tau—and the absence of APOE4, which complicates the typical AD profile)",
  "timestamp": "2025-07-26T02:45:19.771425"
}