{
  "ptid_time": "033_S_1309_2007-03-13",
  "img_path": "/data/qiuhui/data/adni/images/033_S_1309/2007-03-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 32,492 mm³, 45.5% above the reference mean. With a Z-score of 1.14 (87.2th percentile), this represents mild enlargement; hippocampal volume measures 5,721 mm³, 25.6% below the reference mean. With a Z-score of -2.87 (0.2th percentile), this represents significant atrophy; whole brain volume measures 1,022,280 mm³, 0.7% below the reference mean. With a Z-score of -0.08 (46.7th percentile), this represents normal volume ; entorhinal cortex volume measures 2,742 mm³, 29.6% below the reference mean. With a Z-score of -2.29 (1.1th percentile), this represents significant atrophy; fusiform gyrus volume measures 18,707 mm³, 2.7% above the reference mean. With a Z-score of 0.31 (62.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,722 mm³, 8.8% below the reference mean. With a Z-score of -0.78 (21.8th percentile), this represents normal volume . ",
  "text_data": "Age is 69.1 years. Gender is Female. Education: 16 years. Handedness: Right. Race: White. Medical history: Cardiovascular; Musculoskeletal; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 27.0. Logical Memory: 5.0. APOEε4 alleles: 2.0. Biomarker levels: Amyloid beta: 570.00 pg/mL (mild reduced); Total tau: 341.90 pg/mL (mild elevated); Phosphorylated tau: 32.46 pg/mL (mild elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the hippocampus and entorhinal cortex, both key regions affected in Alzheimer's disease (AD), alongside mild ventricular enlargement (consistent with atrophy). The clinical profile includes mild cognitive impairment (MMSE 27), APOE4 homozygosity (high genetic risk), and CSF biomarkers (Aβ reduction, elevated tau) supporting AD pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI) due to Alzheimer’s disease** (likely prodromal AD given biomarker evidence).  \n\n**Confidence:** **High** (structural atrophy aligns with AD pattern, biomarkers strongly support AD etiology, and MMSE is borderline normal/MCI).  \n\n*Note: Progression to dementia is likely given APOE4 homozygosity and biomarker severity, but current MMSE does not meet dementia thresholds.*",
  "timestamp": "2025-07-26T05:34:16.335254"
}