{
  "ptid_time": "023_S_0625_2006-06-23",
  "img_path": "/data/qiuhui/data/adni/images/023_S_0625/2006-06-23/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 128,593 mm³, 233.9% above the reference mean. With a Z-score of 5.60 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 7,107 mm³, 6.0% below the reference mean. With a Z-score of -0.58 (28.0th percentile), this represents normal volume ; whole brain volume measures 1,194,450 mm³, 10.7% above the reference mean. With a Z-score of 1.38 (91.7th percentile), this represents mild enlargement; entorhinal cortex volume measures 2,621 mm³, 36.1% below the reference mean. With a Z-score of -2.45 (0.7th percentile), this represents significant atrophy; fusiform gyrus volume measures 17,094 mm³, 9.3% below the reference mean. With a Z-score of -0.79 (21.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,745 mm³, 7.5% below the reference mean. With a Z-score of -0.67 (25.1th percentile), this represents normal volume . ",
  "text_data": "Age is 75.9 years. Gender is Male. Education: 6 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Major Surgical Procedures. MMSE: 24.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 645.90 pg/mL (normal ); Total tau: 221.30 pg/mL (normal ); Phosphorylated tau: 20.33 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (Z-score 5.60) and entorhinal cortex atrophy (Z-score -2.45), both strong indicators of neurodegeneration. However, hippocampal volume is normal, CSF biomarkers (Aβ, T-tau, P-tau) are normal, and MMSE (24) is borderline but not severely impaired.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (Structural changes suggest neurodegeneration, but normal biomarkers and preserved hippocampal volume make dementia less likely.)",
  "timestamp": "2025-07-26T02:45:26.427874"
}