{
  "ptid_time": "023_S_4796_2014-11-04",
  "img_path": "/data/qiuhui/data/adni/images/023_S_4796/2014-11-04/t1.nii.gz",
  "img_finding": "Image findings: hippocampal volume measures 5,771 mm³, 18.9% below the reference mean. With a Z-score of -1.73 (4.2th percentile), this represents moderate atrophy; whole brain volume measures 939,202 mm³, 3.6% below the reference mean. With a Z-score of -0.46 (32.4th percentile), this represents normal volume ; entorhinal cortex volume measures 2,473 mm³, 32.7% below the reference mean. With a Z-score of -2.01 (2.2th percentile), this represents significant atrophy; fusiform gyrus volume measures 12,794 mm³, 24.8% below the reference mean. With a Z-score of -2.26 (1.2th percentile), this represents significant atrophy; middle temporal gyrus volume measures 14,837 mm³, 22.6% below the reference mean. With a Z-score of -1.96 (2.5th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 74.6 years. Gender is Female. Education: 16 years. MMSE: 20.0. MoCA: 15.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.63 SUVR (profound elevated); Amyloid beta: 727.20 pg/mL (normal ); Total tau: 589.20 pg/mL (profound elevated); Phosphorylated tau: 61.68 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "Reasoning: The patient exhibits significant atrophy in key Alzheimer’s-related regions (hippocampus, entorhinal cortex, fusiform gyrus, middle temporal gyrus) alongside profound elevations in T-tau, P-tau, and AV45 (amyloid PET), despite normal Aβ levels. Cognitive scores (MMSE 20, MoCA 15) indicate moderate impairment. The biomarker profile (elevated tau and AV45 with normal Aβ) is atypical but suggests a tau-predominant neurodegenerative process, possibly atypical AD or a tauopathy.  \n\nDiagnosis: **Dementia**  \nConfidence: **Medium** (due to atypical biomarker pattern but clear structural and cognitive deficits)",
  "timestamp": "2025-07-26T03:08:14.776285"
}