{
  "ptid_time": "014_S_4263_2013-10-31",
  "img_path": "/data/qiuhui/data/adni/images/014_S_4263/2013-10-31/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 74,474 mm³, 93.4% above the reference mean. With a Z-score of 2.24 (98.7th percentile), this represents significant enlargement; hippocampal volume measures 6,193 mm³, 18.1% below the reference mean. With a Z-score of -1.76 (3.9th percentile), this represents moderate atrophy; whole brain volume measures 1,096,210 mm³, 1.6% above the reference mean. With a Z-score of 0.20 (58.0th percentile), this represents normal volume ; entorhinal cortex volume measures 3,605 mm³, 12.1% below the reference mean. With a Z-score of -0.82 (20.6th percentile), this represents normal volume ; fusiform gyrus volume measures 24,699 mm³, 31.1% above the reference mean. With a Z-score of 2.65 (99.6th percentile), this represents significant enlargement; middle temporal gyrus volume measures 24,328 mm³, 14.0% above the reference mean. With a Z-score of 1.26 (89.6th percentile), this represents mild enlargement. ",
  "text_data": "Age is 76.3 years. Gender is Male. Education: 20 years. MMSE: 25.0. MoCA: 20.0. Logical Memory: 2.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.83 SUVR (profound elevated); Amyloid beta: 613.30 pg/mL (mild reduced); Total tau: 422.90 pg/mL (significant elevated); Phosphorylated tau: 41.42 pg/mL (significant elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging shows significant ventricular enlargement (consistent with atrophy) and moderate hippocampal atrophy, both hallmark features of Alzheimer's disease (AD). The CSF biomarkers (elevated T-tau, P-tau, and reduced Aβ) along with profound AV45 (amyloid PET) positivity strongly support AD pathology. The cognitive scores (MMSE 25, MoCA 20) indicate mild cognitive impairment, but the biomarker profile suggests underlying AD progression.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**  \n\n(Key findings: Hippocampal atrophy + AD biomarkers + cognitive decline = high-confidence AD dementia diagnosis.)",
  "timestamp": "2025-07-25T23:53:31.333811"
}