{
  "ptid_time": "168_S_6142_2020-03-04",
  "img_path": "/data/qiuhui/data/adni/images/168_S_6142/2020-03-04/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 31,204 mm³, 15.6% below the reference mean. With a Z-score of -0.42 (33.7th percentile), this represents normal volume ; hippocampal volume measures 4,251 mm³, 34.5% below the reference mean. With a Z-score of -2.77 (0.3th percentile), this represents significant atrophy; whole brain volume measures 794,847 mm³, 14.4% below the reference mean. With a Z-score of -1.72 (4.2th percentile), this represents moderate atrophy; entorhinal cortex volume measures 1,383 mm³, 60.1% below the reference mean. With a Z-score of -3.24 (0.1th percentile), this represents profound atrophy; fusiform gyrus volume measures 11,744 mm³, 27.1% below the reference mean. With a Z-score of -2.04 (2.1th percentile), this represents significant atrophy; middle temporal gyrus volume measures 14,037 mm³, 22.1% below the reference mean. With a Z-score of -1.97 (2.4th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 88.1 years. Gender is Female. Education: 15 years. MMSE: 16.0. MoCA: 14.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.31 SUVR (moderate elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in key Alzheimer's-related regions (hippocampus, entorhinal cortex, fusiform gyrus, middle temporal gyrus), alongside moderate whole-brain atrophy. The MMSE (16) and MoCA (14) scores indicate severe cognitive impairment, consistent with dementia. The absence of APOE4 does not rule out Alzheimer's, given the structural and clinical findings.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease given the pattern of atrophy and elevated AV45 amyloid PET).  \n\n**Confidence:** **High** (due to concordance between profound atrophy in AD-vulnerable regions, low cognitive scores, and amyloid positivity).",
  "timestamp": "2025-07-26T17:18:19.074315"
}