{
  "ptid_time": "016_S_0769_2007-08-24",
  "img_path": "/data/qiuhui/data/adni/images/016_S_0769/2007-08-24/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 100,365 mm³, 234.3% above the reference mean. With a Z-score of 5.57 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 5,756 mm³, 28.3% below the reference mean. With a Z-score of -2.83 (0.2th percentile), this represents significant atrophy; whole brain volume measures 1,151,680 mm³, 1.5% above the reference mean. With a Z-score of 0.21 (58.5th percentile), this represents normal volume ; entorhinal cortex volume measures 2,607 mm³, 38.8% below the reference mean. With a Z-score of -2.69 (0.4th percentile), this represents significant atrophy; fusiform gyrus volume measures 18,711 mm³, 6.0% below the reference mean. With a Z-score of -0.50 (30.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,728 mm³, 7.5% below the reference mean. With a Z-score of -0.62 (26.8th percentile), this represents normal volume . ",
  "text_data": "Age is 63.2 years. Gender is Male. Education: 18 years. MMSE: 28.0. Logical Memory: 7.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 544.10 pg/mL (mild reduced); Total tau: 145.20 pg/mL (mild reduced); Phosphorylated tau: 10.97 pg/mL (mild reduced). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound ventricular enlargement and significant atrophy in the hippocampus and entorhinal cortex, which are hallmark structural changes in Alzheimer's disease (AD). However, the MMSE score of 28 is within the normal range, and CSF biomarkers (Aβ, T-tau, P-tau) are only mildly reduced, not strongly indicative of AD. The absence of APOE4 also reduces genetic risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely amnestic subtype due to hippocampal/entorhinal atrophy, but preserved global cognition).  \n\n**Confidence:** **Medium** (structural changes suggest neurodegeneration, but cognitive and biomarker profiles are not definitive for dementia).",
  "timestamp": "2025-07-26T00:07:50.050653"
}