{
  "ptid_time": "023_S_0388_2007-04-13",
  "img_path": "/data/qiuhui/data/adni/images/023_S_0388/2007-04-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 66,869 mm³, 73.6% above the reference mean. With a Z-score of 1.76 (96.1th percentile), this represents moderate enlargement; hippocampal volume measures 6,714 mm³, 11.2% below the reference mean. With a Z-score of -1.09 (13.8th percentile), this represents mild atrophy; whole brain volume measures 1,155,320 mm³, 7.0% above the reference mean. With a Z-score of 0.91 (81.9th percentile), this represents normal volume ; entorhinal cortex volume measures 2,737 mm³, 33.3% below the reference mean. With a Z-score of -2.26 (1.2th percentile), this represents significant atrophy; fusiform gyrus volume measures 16,911 mm³, 10.2% below the reference mean. With a Z-score of -0.87 (19.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,897 mm³, 2.1% below the reference mean. With a Z-score of -0.19 (42.6th percentile), this represents normal volume . ",
  "text_data": "Age is 72.2 years. Gender is Male. Education: 15 years. MMSE: 27.0. Logical Memory: 8.0. APOEε4 alleles: 2.0. Biomarker levels: Amyloid beta: 313.60 pg/mL (moderate reduced); Total tau: 344.60 pg/mL (mild elevated); Phosphorylated tau: 32.95 pg/mL (mild elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant atrophy in the entorhinal cortex (Z-score -2.26, 1.2th percentile) and mild hippocampal atrophy (Z-score -1.09), both key regions in Alzheimer's pathology. Combined with moderate Aβ reduction and mild tau elevation, this suggests neurodegenerative changes consistent with early Alzheimer’s disease, despite the relatively preserved MMSE (27/30).  \n\n**Diagnosis:** **Mild Cognitive Impairment (MCI) due to Alzheimer’s disease**  \n**Confidence:** **High**  \n\n*(Rationale: Structural atrophy in AD-vulnerable regions + biomarker evidence of amyloid/tau pathology strongly supports MCI-AD, even with near-normal MMSE. The absence of functional decline rules out dementia at this stage.)*",
  "timestamp": "2025-07-26T02:43:13.511236"
}