{
  "ptid_time": "006_S_4153_2013-09-16",
  "img_path": "/data/qiuhui/data/adni/images/006_S_4153/2013-09-16/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 46,607 mm³, 0.9% below the reference mean. With a Z-score of -0.03 (49.0th percentile), this represents normal volume ; hippocampal volume measures 5,088 mm³, 27.0% below the reference mean. With a Z-score of -2.33 (1.0th percentile), this represents significant atrophy; whole brain volume measures 1,116,330 mm³, 8.5% above the reference mean. With a Z-score of 1.11 (86.6th percentile), this represents mild enlargement; entorhinal cortex volume measures 1,842 mm³, 53.6% below the reference mean. With a Z-score of -3.51 (0.0th percentile), this represents profound atrophy; fusiform gyrus volume measures 13,126 mm³, 27.3% below the reference mean. With a Z-score of -2.37 (0.9th percentile), this represents significant atrophy; middle temporal gyrus volume measures 15,692 mm³, 22.2% below the reference mean. With a Z-score of -1.99 (2.3th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 81.3 years. Gender is Male. Education: 20 years. MMSE: 19.0. MoCA: 16.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.52 SUVR (profound elevated); Amyloid beta: 448.20 pg/mL (moderate reduced); Total tau: 424.00 pg/mL (significant elevated); Phosphorylated tau: 43.51 pg/mL (significant 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 abnormal CSF biomarkers (elevated tau, reduced Aβ) and a positive amyloid PET scan (AV45). Cognitive testing (MMSE 19, MoCA 16) indicates moderate impairment.  \n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**  \n\n(APOE4 positivity and profound entorhinal/hippocampal atrophy strongly support AD pathology, while global atrophy patterns and biomarker profiles are highly consistent with dementia-stage AD.)",
  "timestamp": "2025-07-25T21:35:21.617975"
}