{
  "ptid_time": "036_S_0869_2007-05-08",
  "img_path": "/data/qiuhui/data/adni/images/036_S_0869/2007-05-08/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 36,058 mm³, 2.5% below the reference mean. With a Z-score of -0.07 (47.4th percentile), this represents normal volume ; hippocampal volume measures 4,433 mm³, 31.7% below the reference mean. With a Z-score of -2.54 (0.5th percentile), this represents significant atrophy; whole brain volume measures 805,582 mm³, 13.2% below the reference mean. With a Z-score of -1.59 (5.6th percentile), this represents moderate atrophy; entorhinal cortex volume measures 2,087 mm³, 39.7% below the reference mean. With a Z-score of -2.14 (1.6th percentile), this represents significant atrophy; fusiform gyrus volume measures 13,073 mm³, 18.9% below the reference mean. With a Z-score of -1.42 (7.8th percentile), this represents mild atrophy; middle temporal gyrus volume measures 13,920 mm³, 22.8% below the reference mean. With a Z-score of -2.03 (2.1th percentile), this represents significant atrophy. ",
  "text_data": "Age is 83.4 years. Gender is Female. Education: 16 years. MMSE: 25.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the hippocampus, entorhinal cortex, and middle temporal gyrus—key regions affected in Alzheimer’s disease. The MMSE score of 25 is borderline but still within the normal range for age, though the structural changes suggest neurodegeneration. The presence of one APOE4 allele further increases Alzheimer’s risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given the atrophy pattern).  \n\n**Confidence:** **Medium** (clinical correlation needed—cognitive testing beyond MMSE would strengthen the diagnosis).  \n\n*(Note: If additional cognitive deficits are confirmed, progression to dementia due to Alzheimer’s would be likely.)*",
  "timestamp": "2025-07-26T06:06:14.796747"
}