{
  "ptid_time": "057_S_1269_2007-01-31",
  "img_path": "/data/qiuhui/data/adni/images/057_S_1269/2007-01-31/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 43,176 mm³, 12.1% above the reference mean. With a Z-score of 0.29 (61.4th percentile), this represents normal volume ; hippocampal volume measures 6,714 mm³, 11.2% below the reference mean. With a Z-score of -1.09 (13.8th percentile), this represents mild atrophy; whole brain volume measures 1,028,650 mm³, 4.7% below the reference mean. With a Z-score of -0.61 (27.1th percentile), this represents normal volume ; entorhinal cortex volume measures 3,860 mm³, 5.9% below the reference mean. With a Z-score of -0.40 (34.5th percentile), this represents normal volume ; fusiform gyrus volume measures 17,980 mm³, 4.6% below the reference mean. With a Z-score of -0.39 (34.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 23,083 mm³, 8.2% above the reference mean. With a Z-score of 0.73 (76.9th percentile), this represents normal volume . ",
  "text_data": "Age is 73.4 years. Gender is Male. Education: 20 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Malignancy; Major Surgical Procedures. MMSE: 27.0. Logical Memory: 8.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 997.60 pg/mL (normal ); Total tau: 446.70 pg/mL (significant elevated); Phosphorylated tau: 46.20 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "Reasoning: The hippocampal volume shows mild atrophy (Z-score -1.09, 13.8th percentile), which is concerning for early neurodegenerative changes. Elevated T-tau and P-tau suggest neuronal injury and tau pathology, but normal Aβ rules out Alzheimer's pathology. MMSE is normal (27/30), and other brain volumes are within normal ranges.  \nDiagnosis: **MCI** (likely non-AD etiology given normal Aβ but elevated tau)  \nConfidence: **Medium** (hippocampal atrophy and tau elevation support MCI, but unclear etiology due to normal Aβ)",
  "timestamp": "2025-07-26T08:10:30.939146"
}