{
  "ptid_time": "067_S_0176_2006-04-03",
  "img_path": "/data/qiuhui/data/adni/images/067_S_0176/2006-04-03/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 34,117 mm³, 11.4% below the reference mean. With a Z-score of -0.27 (39.2th percentile), this represents normal volume ; hippocampal volume measures 5,881 mm³, 22.2% below the reference mean. With a Z-score of -2.17 (1.5th percentile), this represents significant atrophy; whole brain volume measures 1,003,220 mm³, 7.1% below the reference mean. With a Z-score of -0.92 (18.0th percentile), this represents normal volume ; entorhinal cortex volume measures 2,971 mm³, 27.5% below the reference mean. With a Z-score of -1.87 (3.1th percentile), this represents moderate atrophy; fusiform gyrus volume measures 16,889 mm³, 10.3% below the reference mean. With a Z-score of -0.88 (18.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,271 mm³, 5.0% below the reference mean. With a Z-score of -0.45 (32.6th percentile), this represents normal volume . ",
  "text_data": "Age is 74.7 years. Gender is Male. Education: 19 years. MMSE: 28.0. Logical Memory: 3.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 670.70 pg/mL (normal ); Total tau: 366.60 pg/mL (moderate elevated); Phosphorylated tau: 40.90 pg/mL (significant elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal and entorhinal cortex volumes show significant and moderate atrophy, respectively, which are key regions affected in Alzheimer's disease. Elevated P-tau and moderately elevated T-tau, along with normal Aβ, suggest tau pathology consistent with Alzheimer's, despite the normal MMSE score (which may reflect early-stage preservation of cognitive function).  \n\n**Diagnosis:** **MCI (likely due to Alzheimer’s pathology)**  \n**Confidence:** **Medium** (due to normal Aβ but strong tau and structural atrophy markers; clinical correlation needed for progression to dementia).",
  "timestamp": "2025-07-26T08:26:05.138073"
}