{
  "ptid_time": "129_S_1246_2007-02-06",
  "img_path": "/data/qiuhui/data/adni/images/129_S_1246/2007-02-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 18,841 mm³, 51.1% below the reference mean. With a Z-score of -1.22 (11.1th percentile), this represents mild atrophy; hippocampal volume measures 8,391 mm³, 11.0% above the reference mean. With a Z-score of 1.07 (85.8th percentile), this represents mild enlargement; whole brain volume measures 1,064,250 mm³, 1.4% below the reference mean. With a Z-score of -0.18 (42.8th percentile), this represents normal volume ; entorhinal cortex volume measures 3,715 mm³, 9.4% below the reference mean. With a Z-score of -0.64 (26.2th percentile), this represents normal volume ; fusiform gyrus volume measures 19,889 mm³, 5.6% above the reference mean. With a Z-score of 0.48 (68.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 25,117 mm³, 17.7% above the reference mean. With a Z-score of 1.59 (94.4th percentile), this represents moderate enlargement. ",
  "text_data": "Age is 72.4 years. Gender is Male. Education: 14 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Head, Eyes, Ears, Nose and Throat; Musculoskeletal; Endocrine-Metabolic; Renal-Genitourinary. MMSE: 29.0. Logical Memory: 4.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 723.10 pg/mL (normal ); Total tau: 528.60 pg/mL (profound elevated); Phosphorylated tau: 54.61 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows mild ventricular atrophy (Z-score -1.22) and mild hippocampal enlargement (Z-score 1.07), while other regions are largely within normal ranges. Clinically, the patient has a high MMSE (29/30), normal Aβ, but profoundly elevated T-tau and P-tau, which are atypical for typical Alzheimer’s pathology. The preserved hippocampal volume and normal Aβ suggest non-Alzheimer’s neurodegeneration or a tauopathy.  \n\n**Diagnosis:** **MCI** (given elevated tau biomarkers and mild atrophy, but preserved cognition and no clear dementia symptoms).  \n\n**Confidence:** **Medium** (due to conflicting biomarkers—elevated tau without Aβ pathology is unusual for AD, and structural changes are mild).",
  "timestamp": "2025-07-26T14:10:40.922083"
}