{
  "ptid_time": "022_S_0544_2007-07-06",
  "img_path": "/data/qiuhui/data/adni/images/022_S_0544/2007-07-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 55,105 mm³, 96.3% above the reference mean. With a Z-score of 2.21 (98.6th percentile), this represents significant enlargement; hippocampal volume measures 4,421 mm³, 37.9% below the reference mean. With a Z-score of -3.47 (0.0th percentile), this represents profound atrophy; whole brain volume measures 850,181 mm³, 12.8% below the reference mean. With a Z-score of -1.61 (5.4th percentile), this represents moderate atrophy; entorhinal cortex volume measures 2,733 mm³, 25.6% below the reference mean. With a Z-score of -1.57 (5.8th percentile), this represents moderate atrophy; fusiform gyrus volume measures 14,106 mm³, 17.1% below the reference mean. With a Z-score of -1.56 (6.0th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 16,377 mm³, 14.6% below the reference mean. With a Z-score of -1.26 (10.3th percentile), this represents mild atrophy. ",
  "text_data": "Age is 77.7 years. Gender is Female. Education: 12 years. MMSE: 29.0. Logical Memory: 7.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 467.90 pg/mL (mild reduced); Total tau: 145.00 pg/mL (mild reduced); Phosphorylated tau: 11.63 pg/mL (mild reduced). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant hippocampal atrophy (Z-score -3.47) and ventricular enlargement (Z-score 2.21), which are strong indicators of neurodegeneration, particularly Alzheimer's disease. However, the MMSE score of 29 is within the normal range, and CSF biomarkers (Aβ, T-tau, P-tau) are only mildly reduced, which is atypical for advanced AD.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to the discrepancy between structural atrophy and preserved cognitive function, along with inconclusive biomarkers).",
  "timestamp": "2025-07-26T02:06:02.420391"
}