{
  "ptid_time": "082_S_6690_2019-04-30",
  "img_path": "/data/qiuhui/data/adni/images/082_S_6690/2019-04-30/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 70,762 mm³, 216.8% above the reference mean. With a Z-score of 5.43 (100.0th percentile), this represents profound enlargement; hippocampal volume measures 5,074 mm³, 34.0% below the reference mean. With a Z-score of -3.81 (0.0th percentile), this represents profound atrophy; whole brain volume measures 950,925 mm³, 7.6% below the reference mean. With a Z-score of -0.95 (17.2th percentile), this represents normal volume ; entorhinal cortex volume measures 1,616 mm³, 58.5% below the reference mean. With a Z-score of -4.53 (0.0th percentile), this represents profound atrophy; fusiform gyrus volume measures 12,474 mm³, 31.5% below the reference mean. With a Z-score of -3.55 (0.0th percentile), this represents profound atrophy; middle temporal gyrus volume measures 15,606 mm³, 23.9% below the reference mean. With a Z-score of -2.13 (1.7th percentile), this represents significant atrophy. ",
  "text_data": "Age is 67.7 years. Gender is Female. Education: 14 years. Handedness: Right. Race: White. MMSE: 20.0. MoCA: 7.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.17 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows profound atrophy in key Alzheimer’s-related regions (hippocampus, entorhinal cortex, fusiform gyrus, middle temporal gyrus) alongside severe ventricular enlargement, consistent with advanced neurodegeneration. The cognitive scores (MMSE 20, MoCA 7) indicate severe impairment, and while AV45 (amyloid PET) is normal, the structural and clinical findings strongly suggest neurodegenerative dementia, possibly atypical AD or a mixed pathology.  \n\n**Diagnosis:** Dementia  \n**Confidence:** High  \n\n*(Note: The normal AV45 is atypical for classic Alzheimer’s but may reflect non-amyloid pathology, tau-dominant AD, or a comorbid process. Further tau PET or CSF biomarkers could clarify.)*",
  "timestamp": "2025-07-26T10:10:41.125943"
}