{
  "ptid_time": "041_S_1010_2006-12-12",
  "img_path": "/data/qiuhui/data/adni/images/041_S_1010/2006-12-12/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 54,880 mm³, 42.5% above the reference mean. With a Z-score of 1.02 (84.6th percentile), this represents mild enlargement; hippocampal volume measures 5,166 mm³, 31.7% below the reference mean. With a Z-score of -3.09 (0.1th percentile), this represents profound atrophy; whole brain volume measures 1,108,880 mm³, 2.7% above the reference mean. With a Z-score of 0.35 (63.9th percentile), this represents normal volume ; entorhinal cortex volume measures 2,709 mm³, 33.9% below the reference mean. With a Z-score of -2.30 (1.1th percentile), this represents significant atrophy; fusiform gyrus volume measures 16,239 mm³, 13.8% below the reference mean. With a Z-score of -1.18 (12.0th percentile), this represents mild atrophy; middle temporal gyrus volume measures 20,894 mm³, 2.1% below the reference mean. With a Z-score of -0.19 (42.6th percentile), this represents normal volume . ",
  "text_data": "Age is 74.2 years. Gender is Male. Education: 20 years. Handedness: Right. Race: White. Medical history: Psychiatric; Cardiovascular; Musculoskeletal; Gastrointestinal; Hematopoietic-Lymphatic; Allergies or Drug Sensitivities; Malignancy; Major Surgical Procedures. MMSE: 26.0. Logical Memory: 6.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 594.90 pg/mL (mild reduced); Total tau: 305.50 pg/mL (normal ); Phosphorylated tau: 27.78 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound hippocampal atrophy (Z-score -3.09) and significant entorhinal cortex atrophy (Z-score -2.30), both strongly associated with Alzheimer’s pathology. Mild ventricular enlargement and fusiform gyrus atrophy further support neurodegeneration. The MMSE of 26 is borderline, and mild Aβ reduction suggests early amyloid deposition, while normal tau levels do not rule out early AD.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer’s pathology)  \n**Confidence:** **High** (due to clear structural atrophy in AD-vulnerable regions and borderline cognitive scores, though tau levels are normal).",
  "timestamp": "2025-07-26T07:03:07.122631"
}