{
  "ptid_time": "011_S_0022_2006-10-19",
  "img_path": "/data/qiuhui/data/adni/images/011_S_0022/2006-10-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 5,839 mm³, 80.6% below the reference mean. With a Z-score of -1.91 (2.8th percentile), this represents moderate atrophy; hippocampal volume measures 6,495 mm³, 19.1% below the reference mean. With a Z-score of -1.91 (2.8th percentile), this represents moderate atrophy; whole brain volume measures 883,878 mm³, 22.1% below the reference mean. With a Z-score of -3.13 (0.1th percentile), this represents profound atrophy; entorhinal cortex volume measures 2,637 mm³, 38.1% below the reference mean. With a Z-score of -2.64 (0.4th percentile), this represents significant atrophy; fusiform gyrus volume measures 16,035 mm³, 19.5% below the reference mean. With a Z-score of -1.62 (5.3th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 16,200 mm³, 27.7% below the reference mean. With a Z-score of -2.28 (1.1th percentile), this represents significant atrophy. ",
  "text_data": "Age is 64.2 years. Gender is Male. Education: 17 years. MMSE: 27.0. Logical Memory: 15.0. APOEε4 alleles: 1.0. Biomarker levels: Total tau: 301.90 pg/mL (normal ); Phosphorylated tau: 24.89 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data show significant atrophy in multiple brain regions, particularly the whole brain (Z-score -3.13), entorhinal cortex (Z-score -2.64), and middle temporal gyrus (Z-score -2.28), which are strongly associated with Alzheimer's pathology. However, cognitive performance (MMSE 27) remains within normal limits, and CSF biomarkers (T-tau, P-tau) are normal, suggesting no clear biochemical evidence of neurodegeneration.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (structural changes precede clinical symptoms, but cognition is still largely intact).  \n\n**Confidence:** **Medium** (imaging strongly suggests neurodegeneration, but normal MMSE and CSF biomarkers introduce some uncertainty).",
  "timestamp": "2025-07-25T22:40:59.184617"
}