{
  "ptid_time": "023_S_0042_2005-10-31",
  "img_path": "/data/qiuhui/data/adni/images/023_S_0042/2005-10-31/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 48,933 mm³, 27.0% above the reference mean. With a Z-score of 0.65 (74.1th percentile), this represents normal volume ; hippocampal volume measures 4,087 mm³, 45.9% below the reference mean. With a Z-score of -4.48 (0.0th percentile), this represents profound atrophy; whole brain volume measures 952,780 mm³, 11.7% below the reference mean. With a Z-score of -1.52 (6.4th percentile), this represents moderate atrophy; entorhinal cortex volume measures 2,784 mm³, 32.1% below the reference mean. With a Z-score of -2.18 (1.5th percentile), this represents significant atrophy; fusiform gyrus volume measures 16,454 mm³, 12.7% below the reference mean. With a Z-score of -1.08 (14.0th percentile), this represents mild atrophy; middle temporal gyrus volume measures 16,009 mm³, 25.0% below the reference mean. With a Z-score of -2.25 (1.2th percentile), this represents significant atrophy. ",
  "text_data": "Age is 72.8 years. Gender is Male. Education: 18 years. Handedness: Right. Race: White. Medical history: Musculoskeletal; Endocrine-Metabolic; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking; Malignancy; Major Surgical Procedures. MMSE: 30.0. Logical Memory: 1.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 1258.00 pg/mL (normal ); Total tau: 250.10 pg/mL (normal ); Phosphorylated tau: 18.23 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The patient shows profound hippocampal atrophy and significant atrophy in the entorhinal cortex and middle temporal gyrus, which are hallmark features of Alzheimer's disease. However, cognitive testing (MMSE 30) and CSF biomarkers (Aβ, T-tau, P-tau) are normal, suggesting no current cognitive impairment.  \n\n**Diagnosis:** **CN (Cognitively Normal)** with high-risk imaging profile for future decline.  \n**Confidence:** **Medium** (due to the discrepancy between structural atrophy and preserved cognition/biomarkers).  \n\n*Note:* Despite severe atrophy in memory-related regions, the absence of cognitive or biomarker abnormalities precludes a diagnosis of MCI or dementia at this time. Close monitoring is recommended due to the high-risk imaging profile.",
  "timestamp": "2025-07-26T02:27:58.646870"
}