{
  "ptid_time": "141_S_1052_2006-11-26",
  "img_path": "/data/qiuhui/data/adni/images/141_S_1052/2006-11-26/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 29,760 mm³, 33.2% above the reference mean. With a Z-score of 0.83 (79.7th percentile), this represents normal volume ; hippocampal volume measures 6,729 mm³, 12.4% below the reference mean. With a Z-score of -1.40 (8.1th percentile), this represents mild atrophy; whole brain volume measures 962,926 mm³, 6.4% below the reference mean. With a Z-score of -0.80 (21.2th percentile), this represents normal volume ; entorhinal cortex volume measures 3,372 mm³, 13.4% below the reference mean. With a Z-score of -1.04 (15.0th percentile), this represents mild atrophy; fusiform gyrus volume measures 14,791 mm³, 18.8% below the reference mean. With a Z-score of -2.11 (1.7th percentile), this represents significant atrophy; middle temporal gyrus volume measures 24,225 mm³, 18.1% above the reference mean. With a Z-score of 1.60 (94.6th percentile), this represents moderate enlargement. ",
  "text_data": "Age is 69.0 years. Gender is Female. Education: 8 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Musculoskeletal; Endocrine-Metabolic; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 26.0. Logical Memory: 4.0. APOEε4 alleles: 1.0. Biomarker levels: Total tau: 287.60 pg/mL (normal ); Phosphorylated tau: 25.56 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.40, 8.1th percentile), and the fusiform gyrus exhibits significant atrophy (Z-score -2.11, 1.7th percentile), which are concerning for early neurodegenerative changes. However, the MMSE score of 26 is borderline normal, and CSF biomarkers (T-tau, P-tau) are normal, suggesting no strong evidence of Alzheimer’s pathology at this stage.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting imaging findings and normal biomarkers but significant atrophy in key regions)",
  "timestamp": "2025-07-26T16:53:40.687326"
}