{
  "ptid_time": "027_S_0835_2006-09-11",
  "img_path": "/data/qiuhui/data/adni/images/027_S_0835/2006-09-11/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 31,282 mm³, 18.8% below the reference mean. With a Z-score of -0.45 (32.6th percentile), this represents normal volume ; hippocampal volume measures 5,998 mm³, 20.7% below the reference mean. With a Z-score of -2.01 (2.2th percentile), this represents significant atrophy; whole brain volume measures 1,095,220 mm³, 1.5% above the reference mean. With a Z-score of 0.19 (57.5th percentile), this represents normal volume ; entorhinal cortex volume measures 3,241 mm³, 21.0% below the reference mean. With a Z-score of -1.42 (7.8th percentile), this represents mild atrophy; fusiform gyrus volume measures 15,933 mm³, 15.4% below the reference mean. With a Z-score of -1.31 (9.4th percentile), this represents mild atrophy; middle temporal gyrus volume measures 19,304 mm³, 9.5% below the reference mean. With a Z-score of -0.86 (19.6th percentile), this represents normal volume . ",
  "text_data": "Age is 72.7 years. Gender is Male. Education: 14 years. Handedness: Right. Race: White. Medical history: Psychiatric; Respiratory; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Renal-Genitourinary; Smoking. MMSE: 26.0. Logical Memory: 2.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 562.60 pg/mL (mild reduced); Total tau: 281.50 pg/mL (normal ); Phosphorylated tau: 28.62 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows significant atrophy (Z-score -2.01, 2.2nd percentile), and the entorhinal cortex and fusiform gyrus exhibit mild atrophy, which are key regions affected in Alzheimer's disease. The MMSE score of 26 is borderline, and Aβ is mildly reduced, suggesting early pathological changes. However, T-tau and P-tau are normal, which may indicate a less aggressive progression.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer's pathology)  \n**Confidence:** **Medium** (due to conflicting biomarkers—hippocampal atrophy supports MCI/AD, but normal tau levels introduce some uncertainty).",
  "timestamp": "2025-07-26T03:41:27.289913"
}