{
  "ptid_time": "099_S_0291_2007-04-02",
  "img_path": "/data/qiuhui/data/adni/images/099_S_0291/2007-04-02/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 53,754 mm³, 14.3% above the reference mean. With a Z-score of 0.42 (66.1th percentile), this represents normal volume ; hippocampal volume measures 6,770 mm³, 2.8% below the reference mean. With a Z-score of -0.25 (40.3th percentile), this represents normal volume ; whole brain volume measures 941,071 mm³, 8.6% below the reference mean. With a Z-score of -1.12 (13.1th percentile), this represents mild atrophy; entorhinal cortex volume measures 4,268 mm³, 7.5% above the reference mean. With a Z-score of 0.49 (68.9th percentile), this represents normal volume ; fusiform gyrus volume measures 17,988 mm³, 0.4% below the reference mean. With a Z-score of -0.04 (48.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,105 mm³, 0.3% below the reference mean. With a Z-score of -0.03 (48.8th percentile), this represents normal volume . ",
  "text_data": "Age is 80.4 years. Gender is Male. Education: 16 years. MMSE: 28.0. Logical Memory: 5.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 960.20 pg/mL (normal ); Total tau: 410.20 pg/mL (significant elevated); Phosphorylated tau: 37.27 pg/mL (significant elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The brain imaging shows mild whole-brain atrophy (Z-score -1.12, 13.1th percentile), but hippocampal and other regional volumes are within normal ranges. The MMSE score of 28 is normal, but CSF biomarkers (elevated T-tau and P-tau with normal Aβ) suggest Alzheimer’s pathology. The APOE4 carrier status increases AD risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer’s pathology)  \n**Confidence:** **Medium** (due to normal MMSE but biomarker evidence of neurodegeneration)",
  "timestamp": "2025-07-26T10:53:58.988048"
}