{
  "ptid_time": "033_S_1309_2007-02-08",
  "img_path": "/data/qiuhui/data/adni/images/033_S_1309/2007-02-08/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 data shows significant atrophy in the hippocampus and entorhinal cortex, both critical regions for memory and early Alzheimer's pathology. Mild ventricular enlargement and normal whole-brain volume suggest early-stage neurodegeneration rather than widespread atrophy. The MMSE score of 27 is borderline, and the presence of APOE4 homozygosity, along with mildly abnormal CSF biomarkers (reduced Aβ, elevated T-tau and P-tau), supports Alzheimer's pathology.  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI) due to Alzheimer's disease**  \n**Confidence:** **High**  \n\n(Note: While the MMSE is near-normal, the structural and biomarker evidence strongly suggests MCI with high likelihood of progression to dementia. If functional impairment were more clearly documented, a diagnosis of mild dementia could also be considered.)",
  "timestamp": "2025-07-26T05:34:10.850310"
}