{
  "ptid_time": "027_S_0417_2006-05-12",
  "img_path": "/data/qiuhui/data/adni/images/027_S_0417/2006-05-12/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 100,029 mm³, 159.7% above the reference mean. With a Z-score of 3.83 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 5,975 mm³, 21.0% below the reference mean. With a Z-score of -2.04 (2.0th percentile), this represents significant atrophy; whole brain volume measures 1,156,320 mm³, 7.1% above the reference mean. With a Z-score of 0.93 (82.3th percentile), this represents normal volume ; entorhinal cortex volume measures 3,211 mm³, 21.7% below the reference mean. With a Z-score of -1.47 (7.1th percentile), this represents mild atrophy; fusiform gyrus volume measures 19,149 mm³, 1.6% above the reference mean. With a Z-score of 0.14 (55.6th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,746 mm³, 21.5% below the reference mean. With a Z-score of -1.93 (2.7th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 79.8 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Respiratory; Musculoskeletal; Renal-Genitourinary; Smoking; Malignancy; Major Surgical Procedures. MMSE: 26.0. Logical Memory: 4.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 542.80 pg/mL (mild reduced); Total tau: 328.40 pg/mL (mild elevated); Phosphorylated tau: 28.99 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant hippocampal atrophy (Z-score -2.04) and moderate atrophy in the middle temporal gyrus (Z-score -1.93), both key regions in Alzheimer's pathology. Ventricular enlargement (Z-score 3.83) further supports neurodegeneration, while mild Aβ reduction and elevated T-tau align with early AD biomarkers. The MMSE of 26 is borderline but does not yet indicate severe cognitive impairment.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer's pathology)  \n\n**Confidence:** **High** (structural and biomarker evidence strongly suggests early neurodegenerative changes, though not yet meeting full dementia criteria).",
  "timestamp": "2025-07-26T03:38:15.711397"
}