{
  "ptid_time": "128_S_1148_2008-01-17",
  "img_path": "/data/qiuhui/data/adni/images/128_S_1148/2008-01-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 51,392 mm³, 83.1% above the reference mean. With a Z-score of 1.90 (97.1th percentile), this represents moderate enlargement; hippocampal volume measures 5,331 mm³, 25.1% below the reference mean. With a Z-score of -2.30 (1.1th percentile), this represents significant atrophy; whole brain volume measures 948,576 mm³, 2.7% below the reference mean. With a Z-score of -0.34 (36.8th percentile), this represents normal volume ; entorhinal cortex volume measures 2,523 mm³, 31.3% below the reference mean. With a Z-score of -1.92 (2.7th percentile), this represents moderate atrophy; fusiform gyrus volume measures 14,651 mm³, 13.9% below the reference mean. With a Z-score of -1.26 (10.3th percentile), this represents mild atrophy; middle temporal gyrus volume measures 14,463 mm³, 24.6% below the reference mean. With a Z-score of -2.13 (1.7th percentile), this represents significant atrophy. ",
  "text_data": "Age is 70.7 years. Gender is Female. Education: 14 years. MMSE: 24.0. Logical Memory: 3.0. APOEε4 alleles: 2.0. Biomarker levels: Amyloid beta: 480.00 pg/mL (mild reduced); Total tau: 384.20 pg/mL (moderate elevated); Phosphorylated tau: 35.11 pg/mL (moderate elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant hippocampal atrophy (Z-score -2.30) and moderate entorhinal cortex atrophy (Z-score -1.92), both key regions in Alzheimer's pathology. Combined with elevated tau biomarkers (moderate T-tau and P-tau) and mildly reduced Aβ, this strongly suggests Alzheimer's neurodegeneration. The MMSE score of 24 indicates cognitive impairment but not severe dementia.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI) due to Alzheimer’s disease**  \n**Confidence:** **High**  \n\n*(Note: The presence of significant atrophy in memory-related structures, biomarker evidence of amyloid and tau pathology, and mild cognitive decline align with MCI-AD. Progression to dementia is likely but not yet met based on MMSE.)*",
  "timestamp": "2025-07-26T13:53:14.509777"
}