{
  "ptid_time": "137_S_0796_2006-08-21",
  "img_path": "/data/qiuhui/data/adni/images/137_S_0796/2006-08-21/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 116,677 mm³, 148.2% above the reference mean. With a Z-score of 4.30 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 8,432 mm³, 21.0% above the reference mean. With a Z-score of 1.82 (96.5th percentile), this represents moderate enlargement; whole brain volume measures 1,122,440 mm³, 9.1% above the reference mean. With a Z-score of 1.19 (88.3th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,299 mm³, 16.9% below the reference mean. With a Z-score of -1.11 (13.5th percentile), this represents mild atrophy; fusiform gyrus volume measures 16,699 mm³, 7.6% below the reference mean. With a Z-score of -0.66 (25.6th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,886 mm³, 13.5% above the reference mean. With a Z-score of 1.21 (88.6th percentile), this represents mild enlargement. ",
  "text_data": "Age is 80.3 years. Gender is Male. Education: 14 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 26.0. Logical Memory: 4.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 1071.00 pg/mL (normal ); Total tau: 154.20 pg/mL (mild reduced); Phosphorylated tau: 13.11 pg/mL (mild reduced). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (indicative of brain atrophy) and mild entorhinal cortex atrophy, which are concerning for neurodegenerative changes. However, hippocampal volume is moderately enlarged (unusual in Alzheimer's), Aβ is normal, and tau levels are reduced, making typical Alzheimer's pathology unlikely. The MMSE of 26 is borderline but not definitive for dementia.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting imaging findings—ventricular enlargement suggests atrophy, but preserved hippocampal volume and normal Aβ reduce confidence in a dementia diagnosis).",
  "timestamp": "2025-07-26T16:17:16.406274"
}