{
  "ptid_time": "032_S_1169_2007-01-24",
  "img_path": "/data/qiuhui/data/adni/images/032_S_1169/2007-01-24/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 22,807 mm³, 18.7% below the reference mean. With a Z-score of -0.43 (33.4th percentile), this represents normal volume ; hippocampal volume measures 5,547 mm³, 22.0% below the reference mean. With a Z-score of -2.02 (2.2th percentile), this represents significant atrophy; whole brain volume measures 967,056 mm³, 0.8% below the reference mean. With a Z-score of -0.10 (46.1th percentile), this represents normal volume ; entorhinal cortex volume measures 2,413 mm³, 34.3% below the reference mean. With a Z-score of -2.11 (1.8th percentile), this represents significant atrophy; fusiform gyrus volume measures 15,304 mm³, 10.0% below the reference mean. With a Z-score of -0.91 (18.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,580 mm³, 12.6% above the reference mean. With a Z-score of 1.09 (86.3th percentile), this represents mild enlargement. ",
  "text_data": "Age is 72.2 years. Gender is Female. Education: 18 years. MMSE: 30.0. Logical Memory: 14.0. APOEε4 alleles: 0.0. Biomarker levels: Total tau: 359.00 pg/mL (mild elevated); Phosphorylated tau: 34.78 pg/mL (moderate elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in the hippocampus and entorhinal cortex (Z-scores ≤ -2.0), which are key regions affected in Alzheimer's disease (AD), despite normal MMSE (30/30). Elevated T-tau and P-tau further support AD pathology. However, preserved global cognition and lack of APOE4 suggest a less aggressive or early-stage process.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to underlying AD pathology).  \n**Confidence:** **Medium** (high biomarker evidence but discordant normal MMSE).  \n\n*Note:* MCI is favored over dementia due to intact daily functioning (implied by MMSE 30), but progression to dementia is likely given biomarker severity. Low confidence in \"CN\" due to clear neurodegeneration; low confidence in \"Dementia\" due to lack of functional decline.",
  "timestamp": "2025-07-26T04:59:56.943990"
}