{
  "ptid_time": "032_S_1101_2006-11-21",
  "img_path": "/data/qiuhui/data/adni/images/032_S_1101/2006-11-21/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 20,424 mm³, 27.2% below the reference mean. With a Z-score of -0.62 (26.6th percentile), this represents normal volume ; hippocampal volume measures 4,889 mm³, 31.3% below the reference mean. With a Z-score of -2.87 (0.2th percentile), this represents significant atrophy; whole brain volume measures 750,109 mm³, 23.0% below the reference mean. With a Z-score of -2.90 (0.2th percentile), this represents significant atrophy; entorhinal cortex volume measures 2,785 mm³, 24.2% below the reference mean. With a Z-score of -1.48 (6.9th percentile), this represents mild atrophy; fusiform gyrus volume measures 11,129 mm³, 34.6% below the reference mean. With a Z-score of -3.15 (0.1th percentile), this represents profound atrophy; middle temporal gyrus volume measures 13,067 mm³, 31.8% below the reference mean. With a Z-score of -2.76 (0.3th percentile), this represents significant atrophy. ",
  "text_data": "Age is 70.9 years. Gender is Female. Education: 12 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Endocrine-Metabolic; Major Surgical Procedures. MMSE: 26.0. Logical Memory: 1.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the hippocampus, whole brain, fusiform gyrus, and middle temporal gyrus, which are key regions affected in Alzheimer's disease. The MMSE score of 26 is borderline, but the structural changes suggest neurodegeneration beyond normal aging.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given the APOE4 carrier status and hippocampal atrophy).  \n\n**Confidence:** **High** (due to clear structural atrophy in AD-vulnerable regions, though MMSE is not severely impaired).  \n\n*Note: Progression to dementia is likely if these biomarkers persist or worsen over time.*",
  "timestamp": "2025-07-26T04:59:28.919296"
}