{
  "ptid_time": "037_S_1421_2008-09-17",
  "img_path": "/data/qiuhui/data/adni/images/037_S_1421/2008-09-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 27,170 mm³, 3.2% below the reference mean. With a Z-score of -0.07 (47.1th percentile), this represents normal volume ; hippocampal volume measures 5,171 mm³, 27.3% below the reference mean. With a Z-score of -2.51 (0.6th percentile), this represents significant atrophy; whole brain volume measures 866,933 mm³, 11.1% below the reference mean. With a Z-score of -1.39 (8.2th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,575 mm³, 29.9% below the reference mean. With a Z-score of -1.83 (3.3th percentile), this represents moderate atrophy; fusiform gyrus volume measures 15,488 mm³, 9.0% below the reference mean. With a Z-score of -0.82 (20.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 15,663 mm³, 18.3% below the reference mean. With a Z-score of -1.59 (5.6th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 75.4 years. Gender is Female. Education: 12 years. MMSE: 28.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. Biomarker levels: Pittsburgh compound B: 2.29 SUVR (moderate elevated); Amyloid beta: 614.30 pg/mL (mild reduced); Total tau: 380.70 pg/mL (moderate elevated); Phosphorylated tau: 44.19 pg/mL (significant elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant hippocampal atrophy (Z-score -2.51, 0.6th percentile) and moderate atrophy in the entorhinal cortex and middle temporal gyrus, which are key regions affected in Alzheimer's disease. Despite a normal MMSE score (28), the presence of elevated P-tau and T-tau with mildly reduced Aβ suggests Alzheimer's pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (due to structural and biomarker evidence of neurodegeneration despite preserved cognitive function on MMSE).  \n\n**Confidence:** **Medium** (while biomarkers and atrophy strongly suggest early Alzheimer's pathology, the lack of significant cognitive decline on MMSE makes dementia diagnosis premature).  \n\n*Note: If clinical history reveals subjective cognitive complaints or subtle deficits not captured by MMSE, MCI is highly likely. Follow-up cognitive testing (e.g., MoCA, neuropsychological battery) would strengthen confidence.*",
  "timestamp": "2025-07-26T06:37:37.335665"
}