{
  "ptid_time": "109_S_0950_2006-10-25",
  "img_path": "/data/qiuhui/data/adni/images/109_S_0950/2006-10-25/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 85,939 mm³, 123.1% above the reference mean. With a Z-score of 2.95 (99.8th percentile), this represents significant enlargement; hippocampal volume measures 5,410 mm³, 28.4% below the reference mean. With a Z-score of -2.77 (0.3th percentile), this represents significant atrophy; whole brain volume measures 905,436 mm³, 16.1% below the reference mean. With a Z-score of -2.09 (1.8th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,814 mm³, 31.4% below the reference mean. With a Z-score of -2.13 (1.7th percentile), this represents significant atrophy; fusiform gyrus volume measures 14,311 mm³, 24.0% below the reference mean. With a Z-score of -2.05 (2.0th percentile), this represents significant atrophy; middle temporal gyrus volume measures 14,605 mm³, 31.6% below the reference mean. With a Z-score of -2.84 (0.2th percentile), this represents significant atrophy. ",
  "text_data": "Age is 73.5 years. Gender is Male. Education: 17 years. MMSE: 26.0. Logical Memory: 6.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 494.00 pg/mL (mild reduced); Total tau: 238.80 pg/mL (normal ); Phosphorylated tau: 25.21 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in multiple brain regions critical for memory and cognition (hippocampus, entorhinal cortex, fusiform gyrus, middle temporal gyrus) alongside ventricular enlargement, strongly suggestive of neurodegeneration. The MMSE score of 26 is borderline, but the structural changes are more severe than expected for normal aging or MCI, aligning more with dementia.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease given hippocampal/entorhinal atrophy and mildly reduced Aβ, though atypical due to normal tau).  \n\n**Confidence:** **Medium** (high confidence in neurodegeneration, but atypical biomarker profile—normal tau and APOE4-negative—warrants further investigation for mixed pathology or non-AD causes).",
  "timestamp": "2025-07-26T11:27:57.993171"
}