{
  "ptid_time": "033_S_1309_2009-02-27",
  "img_path": "/data/qiuhui/data/adni/images/033_S_1309/2009-02-27/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 40,065 mm³, 42.7% above the reference mean. With a Z-score of 0.98 (83.6th percentile), this represents normal volume ; hippocampal volume measures 5,025 mm³, 29.4% below the reference mean. With a Z-score of -2.69 (0.4th percentile), this represents significant atrophy; whole brain volume measures 1,008,360 mm³, 3.5% above the reference mean. With a Z-score of 0.44 (66.8th percentile), this represents normal volume ; entorhinal cortex volume measures 2,788 mm³, 24.1% below the reference mean. With a Z-score of -1.48 (7.0th percentile), this represents mild atrophy; fusiform gyrus volume measures 18,297 mm³, 7.5% above the reference mean. With a Z-score of 0.69 (75.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,867 mm³, 6.8% below the reference mean. With a Z-score of -0.59 (27.8th percentile), this represents normal volume . ",
  "text_data": "Age is 71.1 years. Gender is Female. Education: 16 years. MMSE: 26.0. Logical Memory: 5.0. APOEε4 alleles: 2.0. Biomarker levels: Amyloid beta: 600.30 pg/mL (mild reduced); Total tau: 310.50 pg/mL (normal ); Phosphorylated tau: 28.37 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows significant atrophy (Z-score -2.69, 0.4th percentile), and the entorhinal cortex has mild atrophy (Z-score -1.48, 7.0th percentile), both key regions in Alzheimer's pathology. The MMSE of 26 is borderline, and the presence of two APOE4 alleles along with mildly reduced Aβ suggests early neurodegenerative changes.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given biomarker and atrophy patterns).  \n\n**Confidence:** **Medium** (strong structural and genetic support, but clinical cognitive score is only mildly impaired).",
  "timestamp": "2025-07-26T05:35:19.913449"
}