{
  "ptid_time": "052_S_1250_2007-02-02",
  "img_path": "/data/qiuhui/data/adni/images/052_S_1250/2007-02-02/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 19,143 mm³, 31.8% below the reference mean. With a Z-score of -0.73 (23.3th percentile), this represents normal volume ; hippocampal volume measures 7,409 mm³, 4.1% above the reference mean. With a Z-score of 0.38 (64.8th percentile), this represents normal volume ; whole brain volume measures 805,585 mm³, 17.3% below the reference mean. With a Z-score of -2.18 (1.4th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,746 mm³, 25.2% below the reference mean. With a Z-score of -1.55 (6.1th percentile), this represents moderate atrophy; fusiform gyrus volume measures 16,962 mm³, 0.3% below the reference mean. With a Z-score of -0.03 (48.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 11,546 mm³, 39.8% below the reference mean. With a Z-score of -3.45 (0.0th percentile), this represents profound atrophy. ",
  "text_data": "Age is 73.2 years. Gender is Female. Education: 10 years. Handedness: Right. Race: Black or African American. Medical history: Neurologic; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal. MMSE: 28.0. Logical Memory: 6.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 1643.00 pg/mL (moderate elevated); Total tau: 177.80 pg/mL (normal ); Phosphorylated tau: 16.84 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant whole brain atrophy (Z-score -2.18) and profound middle temporal gyrus atrophy (Z-score -3.45), along with moderate entorhinal cortex atrophy (Z-score -1.55), which are concerning for neurodegenerative changes. However, hippocampal volume is normal, MMSE is intact (28/30), and CSF biomarkers show only moderately elevated Aβ with normal tau, suggesting no strong evidence of active Alzheimer’s pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting biomarkers—structural atrophy without clear Alzheimer’s biomarker support or significant cognitive decline).",
  "timestamp": "2025-07-26T07:44:16.051606"
}