{
  "ptid_time": "016_S_4591_2014-04-15",
  "img_path": "/data/qiuhui/data/adni/images/016_S_4591/2014-04-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 21,680 mm³, 2.9% below the reference mean. With a Z-score of -0.07 (47.1th percentile), this represents normal volume ; hippocampal volume measures 5,346 mm³, 30.4% below the reference mean. With a Z-score of -3.42 (0.0th percentile), this represents profound atrophy; whole brain volume measures 899,234 mm³, 12.6% below the reference mean. With a Z-score of -1.57 (5.8th percentile), this represents moderate atrophy; entorhinal cortex volume measures 2,220 mm³, 43.0% below the reference mean. With a Z-score of -3.33 (0.0th percentile), this represents profound atrophy; fusiform gyrus volume measures 12,935 mm³, 29.0% below the reference mean. With a Z-score of -3.26 (0.1th percentile), this represents profound atrophy; middle temporal gyrus volume measures 14,978 mm³, 27.0% below the reference mean. With a Z-score of -2.40 (0.8th percentile), this represents significant atrophy. ",
  "text_data": "Age is 67.9 years. Gender is Female. Education: 13 years. MMSE: 21.0. MoCA: 8.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.55 SUVR (profound elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "Reasoning: The imaging data shows profound atrophy in key Alzheimer's-related regions (hippocampus, entorhinal cortex, fusiform gyrus) and moderate-to-significant atrophy in broader structures (whole brain, middle temporal gyrus). Combined with profoundly elevated amyloid (AV45), APOE4 positivity, and severely impaired cognitive scores (MMSE 21, MoCA 8), this strongly suggests neurodegenerative disease.  \n\nDiagnosis: **Dementia** (likely Alzheimer’s disease given the amyloid burden and medial temporal lobe atrophy pattern).  \nConfidence: **High** (imaging, biomarkers, and clinical scores all align with advanced AD).",
  "timestamp": "2025-07-26T00:28:01.750250"
}