{
  "ptid_time": "133_S_0727_2007-03-15",
  "img_path": "/data/qiuhui/data/adni/images/133_S_0727/2007-03-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 62,551 mm³, 180.0% above the reference mean. With a Z-score of 4.51 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 5,358 mm³, 30.3% below the reference mean. With a Z-score of -3.40 (0.0th percentile), this represents profound atrophy; whole brain volume measures 999,674 mm³, 2.9% below the reference mean. With a Z-score of -0.36 (36.1th percentile), this represents normal volume ; entorhinal cortex volume measures 3,063 mm³, 21.3% below the reference mean. With a Z-score of -1.65 (4.9th percentile), this represents moderate atrophy; fusiform gyrus volume measures 13,327 mm³, 26.8% below the reference mean. With a Z-score of -3.02 (0.1th percentile), this represents profound atrophy; middle temporal gyrus volume measures 15,146 mm³, 26.2% below the reference mean. With a Z-score of -2.33 (1.0th percentile), this represents significant atrophy. ",
  "text_data": "Age is 69.7 years. Gender is Female. Education: 12 years. MMSE: 28.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows profound hippocampal atrophy (Z-score -3.40), significant atrophy in the entorhinal cortex, fusiform gyrus, and middle temporal gyrus, along with severe ventricular enlargement, all of which are strongly associated with Alzheimer's pathology. However, the MMSE score of 28 is within the normal range, suggesting preserved cognitive function despite structural changes. The presence of two APOE4 alleles further increases Alzheimer's risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given imaging and APOE4 status, but cognition is still intact per MMSE).  \n\n**Confidence:** **Medium** (high confidence in neurodegenerative changes, but MCI diagnosis is tentative due to normal MMSE; clinical correlation with more sensitive cognitive tests would strengthen certainty).",
  "timestamp": "2025-07-26T15:24:32.892500"
}