{
  "ptid_time": "027_S_1045_2008-11-19",
  "img_path": "/data/qiuhui/data/adni/images/027_S_1045/2008-11-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 33,107 mm³, 10.4% below the reference mean. With a Z-score of -0.28 (38.9th percentile), this represents normal volume ; hippocampal volume measures 5,341 mm³, 17.8% below the reference mean. With a Z-score of -1.42 (7.7th percentile), this represents mild atrophy; whole brain volume measures 938,774 mm³, 1.1% above the reference mean. With a Z-score of 0.14 (55.4th percentile), this represents normal volume ; entorhinal cortex volume measures 1,718 mm³, 50.4% below the reference mean. With a Z-score of -2.72 (0.3th percentile), this represents significant atrophy; fusiform gyrus volume measures 16,409 mm³, 1.9% above the reference mean. With a Z-score of 0.14 (55.6th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,267 mm³, 4.2% below the reference mean. With a Z-score of -0.38 (35.3th percentile), this represents normal volume . ",
  "text_data": "Age is 84.6 years. Gender is Female. Education: 14 years. MMSE: 25.0. Logical Memory: 3.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 1458.00 pg/mL (mild elevated); Total tau: 243.90 pg/mL (normal ); Phosphorylated tau: 20.24 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.42, 7.7th percentile), and the entorhinal cortex exhibits significant atrophy (Z-score -2.72, 0.3rd percentile), both of which are key regions affected in Alzheimer's disease. The MMSE score of 25 is borderline, and mild Aβ elevation suggests early amyloid pathology, but normal tau levels and preserved whole-brain volume argue against advanced neurodegeneration.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to conflicting biomarkers—Aβ elevation but normal tau, and only partial atrophy in AD-vulnerable regions).",
  "timestamp": "2025-07-26T03:44:31.418692"
}