{
  "ptid_time": "052_S_0671_2007-07-04",
  "img_path": "/data/qiuhui/data/adni/images/052_S_0671/2007-07-04/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 13,915 mm³, 37.7% below the reference mean. With a Z-score of -0.94 (17.3th percentile), this represents normal volume ; hippocampal volume measures 6,671 mm³, 13.2% below the reference mean. With a Z-score of -1.48 (6.9th percentile), this represents mild atrophy; whole brain volume measures 949,585 mm³, 7.7% below the reference mean. With a Z-score of -0.96 (16.8th percentile), this represents normal volume ; entorhinal cortex volume measures 2,523 mm³, 35.2% below the reference mean. With a Z-score of -2.73 (0.3th percentile), this represents significant atrophy; fusiform gyrus volume measures 16,170 mm³, 11.2% below the reference mean. With a Z-score of -1.26 (10.4th percentile), this represents mild atrophy; middle temporal gyrus volume measures 17,496 mm³, 14.7% below the reference mean. With a Z-score of -1.31 (9.5th percentile), this represents mild atrophy. ",
  "text_data": "Age is 62.0 years. Gender is Female. Education: 12 years. MMSE: 25.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. Biomarker levels: Amyloid beta: 484.50 pg/mL (mild reduced); Total tau: 331.50 pg/mL (mild elevated); Phosphorylated tau: 34.96 pg/mL (moderate elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the entorhinal cortex (Z-score -2.73, 0.3rd percentile) and mild atrophy in the hippocampus (Z-score -1.48, 6.9th percentile), fusiform gyrus, and middle temporal gyrus—regions critical for memory and cognition. Combined with mildly reduced Aβ, elevated T-tau, and moderately elevated P-tau, this suggests neurodegenerative pathology. The MMSE of 25 is borderline but aligns with early cognitive decline.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given biomarker and atrophy patterns).  \n\n**Confidence:** **High** (structural and biomarker evidence strongly support MCI with Alzheimer’s pathology).  \n\n*(Note: Progression to dementia is likely if atrophy/biomarkers worsen, but current MMSE doesn’t meet dementia thresholds.)*",
  "timestamp": "2025-07-26T07:39:28.667397"
}