{
  "ptid_time": "005_S_0223_2008-03-18",
  "img_path": "/data/qiuhui/data/adni/images/005_S_0223/2008-03-18/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 41,159 mm³, 11.3% above the reference mean. With a Z-score of 0.31 (62.0th percentile), this represents normal volume ; hippocampal volume measures 5,086 mm³, 21.7% below the reference mean. With a Z-score of -1.74 (4.1th percentile), this represents moderate atrophy; whole brain volume measures 948,948 mm³, 2.2% above the reference mean. With a Z-score of 0.27 (60.6th percentile), this represents normal volume ; entorhinal cortex volume measures 1,837 mm³, 46.9% below the reference mean. With a Z-score of -2.53 (0.6th percentile), this represents significant atrophy; fusiform gyrus volume measures 12,967 mm³, 19.5% below the reference mean. With a Z-score of -1.47 (7.1th percentile), this represents mild atrophy; middle temporal gyrus volume measures 15,537 mm³, 13.8% below the reference mean. With a Z-score of -1.23 (10.9th percentile), this represents mild atrophy. ",
  "text_data": "Age is 80.0 years. Gender is Female. Education: 18 years. MMSE: 27.0. Logical Memory: 9.0. Laboratory findings: AST (SGOT): 34.00 (significant elevated). APOEε4 alleles: 1.0. Biomarker levels: Pittsburgh compound B: 1.85 SUVR (normal ); Amyloid beta: 551.50 pg/mL (mild reduced); Total tau: 388.90 pg/mL (moderate elevated); Phosphorylated tau: 36.83 pg/mL (significant elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the entorhinal cortex (Z-score -2.53, 0.6th percentile) and moderate hippocampal atrophy (Z-score -1.74, 4.1th percentile), both key regions affected in Alzheimer's disease. The CSF biomarkers (elevated T-tau and P-tau, mildly reduced Aβ) further support Alzheimer's pathology, while the MMSE score of 27 suggests relatively preserved cognition, likely due to cognitive reserve.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely due to Alzheimer's pathology)  \n**Confidence:** **High** (due to strong biomarker and structural evidence despite near-normal MMSE)",
  "timestamp": "2025-07-25T21:04:07.973536"
}