{
  "ptid_time": "019_S_4549_2012-07-23",
  "img_path": "/data/qiuhui/data/adni/images/019_S_4549/2012-07-23/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 76,410 mm³, 98.4% above the reference mean. With a Z-score of 2.36 (99.1th percentile), this represents significant enlargement; hippocampal volume measures 6,831 mm³, 9.6% below the reference mean. With a Z-score of -0.94 (17.4th percentile), this represents normal volume ; whole brain volume measures 1,226,270 mm³, 13.6% above the reference mean. With a Z-score of 1.77 (96.1th percentile), this represents moderate enlargement; entorhinal cortex volume measures 4,002 mm³, 2.4% below the reference mean. With a Z-score of -0.16 (43.5th percentile), this represents normal volume ; fusiform gyrus volume measures 17,412 mm³, 7.6% below the reference mean. With a Z-score of -0.64 (25.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,667 mm³, 3.1% below the reference mean. With a Z-score of -0.28 (38.9th percentile), this represents normal volume . ",
  "text_data": "Age is 79.0 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Endocrine-Metabolic; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking; Malignancy; Major Surgical Procedures. MMSE: 21.0. MoCA: 20.0. Logical Memory: 2.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.23 SUVR (mild elevated); Amyloid beta: 531.80 pg/mL (mild reduced); Total tau: 315.30 pg/mL (normal ); Phosphorylated tau: 32.02 pg/mL (mild elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant ventricular enlargement (indicative of atrophy) and mild hippocampal volume reduction, alongside cognitive scores (MMSE 21, MoCA 20) below normal thresholds for age. Biomarkers (mildly reduced Aβ, elevated P-tau, and AV45) suggest Alzheimer's pathology, though APOE4-negative status slightly reduces risk.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **Medium** (Cognitive deficits and biomarker profile support AD, but APOE4-negative status and only mild hippocampal atrophy introduce some uncertainty).",
  "timestamp": "2025-07-26T01:07:09.626738"
}