{
  "ptid_time": "018_S_4868_2016-08-18",
  "img_path": "/data/qiuhui/data/adni/images/018_S_4868/2016-08-18/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 34,934 mm³, 25.7% below the reference mean. With a Z-score of -0.75 (22.8th percentile), this represents normal volume ; hippocampal volume measures 5,320 mm³, 23.7% below the reference mean. With a Z-score of -2.04 (2.0th percentile), this represents significant atrophy; whole brain volume measures 981,009 mm³, 4.7% below the reference mean. With a Z-score of -0.61 (27.0th percentile), this represents normal volume ; entorhinal cortex volume measures 2,530 mm³, 36.3% below the reference mean. With a Z-score of -2.37 (0.9th percentile), this represents significant atrophy; fusiform gyrus volume measures 15,097 mm³, 16.4% below the reference mean. With a Z-score of -1.42 (7.7th percentile), this represents mild atrophy; middle temporal gyrus volume measures 18,630 mm³, 7.6% below the reference mean. With a Z-score of -0.69 (24.7th percentile), this represents normal volume . ",
  "text_data": "Age is 81.1 years. Gender is Male. Education: 12 years. MMSE: 24.0. MoCA: 18.0. Logical Memory: 3.0. APOEε4 alleles: 2.0. Biomarker levels: Florbetapir (AV45): 1.43 SUVR (significant elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "Reasoning: The patient shows significant atrophy in the hippocampus and entorhinal cortex (Z-scores ≤ -2.0, ≤ 2nd percentile), which are key regions affected in Alzheimer's disease (AD). Mild atrophy in the fusiform gyrus and normal volumes elsewhere suggest early-stage AD. Cognitive testing (MMSE 24, MoCA 18) indicates mild cognitive impairment, and elevated AV45 (amyloid PET) with APOE4 homozygosity strongly supports AD pathology.  \nDiagnosis: **Dementia (likely Alzheimer’s disease)**  \nConfidence: **High**",
  "timestamp": "2025-07-26T01:01:15.573351"
}