{
  "ptid_time": "116_S_0361_2011-05-20",
  "img_path": "/data/qiuhui/data/adni/images/116_S_0361/2011-05-20/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 51,317 mm³, 33.2% above the reference mean. With a Z-score of 0.80 (78.7th percentile), this represents normal volume ; hippocampal volume measures 6,022 mm³, 20.3% below the reference mean. With a Z-score of -1.98 (2.4th percentile), this represents moderate atrophy; whole brain volume measures 1,024,540 mm³, 5.1% below the reference mean. With a Z-score of -0.66 (25.5th percentile), this represents normal volume ; entorhinal cortex volume measures 2,398 mm³, 41.5% below the reference mean. With a Z-score of -2.82 (0.2th percentile), this represents significant atrophy; fusiform gyrus volume measures 16,131 mm³, 14.4% below the reference mean. With a Z-score of -1.22 (11.0th percentile), this represents mild atrophy; middle temporal gyrus volume measures 17,035 mm³, 20.2% below the reference mean. With a Z-score of -1.81 (3.5th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 79.5 years. Gender is Male. Education: 17 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Malignancy; Major Surgical Procedures. MMSE: 25.0. MoCA: 16.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.51 SUVR (profound elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the entorhinal cortex (Z-score -2.82) and moderate atrophy in the hippocampus (Z-score -1.98) and middle temporal gyrus (Z-score -1.81), which are key regions affected in Alzheimer’s disease. The cognitive scores (MMSE 25, MoCA 16) indicate notable impairment, particularly in executive function and memory, consistent with dementia. The presence of an APOE4 allele and elevated AV45 (amyloid PET) further supports an Alzheimer’s pathology.  \n\n**Diagnosis:** Dementia (likely Alzheimer’s disease)  \n**Confidence:** High",
  "timestamp": "2025-07-26T11:51:57.251185"
}