{
  "ptid_time": "032_S_0978_2006-10-16",
  "img_path": "/data/qiuhui/data/adni/images/032_S_0978/2006-10-16/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 33,648 mm³, 12.6% below the reference mean. With a Z-score of -0.30 (38.1th percentile), this represents normal volume ; hippocampal volume measures 6,250 mm³, 17.3% below the reference mean. With a Z-score of -1.69 (4.6th percentile), this represents moderate atrophy; whole brain volume measures 1,049,840 mm³, 2.7% below the reference mean. With a Z-score of -0.36 (36.1th percentile), this represents normal volume ; entorhinal cortex volume measures 2,331 mm³, 43.2% below the reference mean. With a Z-score of -2.93 (0.2th percentile), this represents significant atrophy; fusiform gyrus volume measures 18,150 mm³, 3.7% below the reference mean. With a Z-score of -0.31 (37.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,868 mm³, 6.9% below the reference mean. With a Z-score of -0.62 (26.8th percentile), this represents normal volume . ",
  "text_data": "Age is 73.1 years. Gender is Male. Education: 12 years. Handedness: Right. Race: White. Medical history: Neurologic; Cardiovascular; Respiratory; Dermatologic-Connective Tissue; Endocrine-Metabolic; Renal-Genitourinary; Smoking; Major Surgical Procedures. MMSE: 29.0. Logical Memory: 4.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 657.60 pg/mL (normal ); Total tau: 409.00 pg/mL (significant elevated); Phosphorylated tau: 37.90 pg/mL (significant elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant atrophy in the hippocampus (Z-score -1.69, 4.6th percentile) and entorhinal cortex (Z-score -2.93, 0.2th percentile), which are key regions affected in Alzheimer's disease. Despite normal Aβ levels, elevated T-tau and P-tau suggest neurodegeneration. The MMSE of 29 is within normal range, but the structural and biomarker findings indicate early pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)**  \n**Confidence:** **Medium** (due to normal MMSE but strong biomarker and structural atrophy evidence)",
  "timestamp": "2025-07-26T04:58:21.292624"
}