{
  "ptid_time": "033_S_1098_2006-12-11",
  "img_path": "/data/qiuhui/data/adni/images/033_S_1098/2006-12-11/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 15,362 mm³, 45.3% below the reference mean. With a Z-score of -1.04 (15.0th percentile), this represents mild atrophy; hippocampal volume measures 7,027 mm³, 1.2% below the reference mean. With a Z-score of -0.11 (45.5th percentile), this represents normal volume ; whole brain volume measures 923,059 mm³, 5.3% below the reference mean. With a Z-score of -0.67 (25.3th percentile), this represents normal volume ; entorhinal cortex volume measures 4,450 mm³, 21.2% above the reference mean. With a Z-score of 1.30 (90.3th percentile), this represents mild enlargement; fusiform gyrus volume measures 17,245 mm³, 1.4% above the reference mean. With a Z-score of 0.12 (54.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,995 mm³, 6.1% below the reference mean. With a Z-score of -0.53 (29.7th percentile), this represents normal volume . ",
  "text_data": "Age is 72.0 years. Gender is Female. Education: 15 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Major Surgical Procedures. MMSE: 29.0. Logical Memory: 20.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 561.70 pg/mL (mild reduced); Total tau: 462.80 pg/mL (significant elevated); Phosphorylated tau: 48.27 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows mild ventricular atrophy but otherwise largely normal brain volumes, including the hippocampus. However, biomarker data (Aβ mildly reduced, T-tau and P-tau significantly elevated) strongly suggests Alzheimer's pathology. The high MMSE score (29/30) indicates preserved cognitive function despite these biomarkers.  \n\n**Diagnosis:** **MCI (Mild Cognitive Impairment, likely due to Alzheimer’s pathology)**  \n**Confidence:** **Medium** (Biomarkers strongly suggest early Alzheimer’s, but cognitive performance remains intact, making this more consistent with MCI than dementia. However, tau elevation is profound, which could indicate faster progression.)  \n\n*Note: Given the tau elevation, close monitoring for rapid decline is warranted.*",
  "timestamp": "2025-07-26T05:28:24.901191"
}