{
  "ptid_time": "033_S_0514_2007-06-07",
  "img_path": "/data/qiuhui/data/adni/images/033_S_0514/2007-06-07/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 111,195 mm³, 136.5% above the reference mean. With a Z-score of 3.96 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 6,576 mm³, 5.6% below the reference mean. With a Z-score of -0.49 (31.3th percentile), this represents normal volume ; whole brain volume measures 1,191,180 mm³, 15.7% above the reference mean. With a Z-score of 2.06 (98.0th percentile), this represents significant enlargement; entorhinal cortex volume measures 3,772 mm³, 5.0% below the reference mean. With a Z-score of -0.32 (37.3th percentile), this represents normal volume ; fusiform gyrus volume measures 15,318 mm³, 15.2% below the reference mean. With a Z-score of -1.32 (9.4th percentile), this represents mild atrophy; middle temporal gyrus volume measures 18,614 mm³, 7.7% below the reference mean. With a Z-score of -0.69 (24.4th percentile), this represents normal volume . ",
  "text_data": "Age is 81.7 years. Gender is Male. Education: 20 years. MMSE: 28.0. Logical Memory: 14.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 873.00 pg/mL (normal ); Total tau: 137.60 pg/mL (mild reduced); Phosphorylated tau: 11.26 pg/mL (mild reduced). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound ventricular enlargement (Z-score 3.96) and significant whole brain enlargement (Z-score 2.06), which are atypical for typical Alzheimer's pathology. Hippocampal and entorhinal cortex volumes are within normal ranges, while fusiform gyrus shows mild atrophy. The MMSE score of 28 is normal, and biomarkers (Aβ normal, T-tau/P-tau mildly reduced) do not support Alzheimer’s. The findings suggest possible non-Alzheimer’s pathology (e.g., normal pressure hydrocephalus or another neurodegenerative process).  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to conflicting imaging findings despite normal cognition and biomarkers)",
  "timestamp": "2025-07-26T05:11:51.913977"
}