{
  "ptid_time": "136_S_0874_2007-11-19",
  "img_path": "/data/qiuhui/data/adni/images/136_S_0874/2007-11-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 18,648 mm³, 16.5% below the reference mean. With a Z-score of -0.41 (34.0th percentile), this represents normal volume ; hippocampal volume measures 5,918 mm³, 23.0% below the reference mean. With a Z-score of -2.58 (0.5th percentile), this represents significant atrophy; whole brain volume measures 1,004,090 mm³, 2.4% below the reference mean. With a Z-score of -0.30 (38.1th percentile), this represents normal volume ; entorhinal cortex volume measures 3,126 mm³, 19.7% below the reference mean. With a Z-score of -1.53 (6.3th percentile), this represents moderate atrophy; fusiform gyrus volume measures 14,841 mm³, 18.5% below the reference mean. With a Z-score of -2.08 (1.9th percentile), this represents significant atrophy; middle temporal gyrus volume measures 14,221 mm³, 30.7% below the reference mean. With a Z-score of -2.73 (0.3th percentile), this represents significant atrophy. ",
  "text_data": "Age is 67.1 years. Gender is Female. Education: 16 years. MMSE: 28.0. Logical Memory: 8.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows significant atrophy (Z-score -2.58, 0.5th percentile), along with moderate to severe atrophy in the entorhinal cortex, fusiform gyrus, and middle temporal gyrus—key regions affected in Alzheimer’s disease. Despite a normal MMSE score (28/30), the structural changes suggest neurodegeneration. The presence of two APOE4 alleles further increases Alzheimer’s risk.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI)** (likely prodromal Alzheimer’s given biomarker profile).  \n\n**Confidence:** **High** (due to clear atrophy in AD-vulnerable regions and APOE4 status, though cognitive scores remain intact).  \n\n*Note: Progression to dementia is likely if atrophy continues; clinical correlation with episodic memory testing (e.g., delayed recall) would strengthen the diagnosis.*",
  "timestamp": "2025-07-26T16:04:53.708021"
}