{
  "ptid_time": "127_S_4928_2014-09-19",
  "img_path": "/data/qiuhui/data/adni/images/127_S_4928/2014-09-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 55,365 mm³, 43.7% above the reference mean. With a Z-score of 1.05 (85.3th percentile), this represents mild enlargement; hippocampal volume measures 4,712 mm³, 37.7% below the reference mean. With a Z-score of -3.67 (0.0th percentile), this represents profound atrophy; whole brain volume measures 1,122,820 mm³, 4.0% above the reference mean. With a Z-score of 0.52 (69.9th percentile), this represents normal volume ; entorhinal cortex volume measures 2,484 mm³, 39.4% below the reference mean. With a Z-score of -2.67 (0.4th percentile), this represents significant atrophy; fusiform gyrus volume measures 15,843 mm³, 15.9% below the reference mean. With a Z-score of -1.35 (8.8th percentile), this represents mild atrophy; middle temporal gyrus volume measures 22,227 mm³, 4.2% above the reference mean. With a Z-score of 0.37 (64.6th percentile), this represents normal volume . ",
  "text_data": "Age is 79.8 years. Gender is Male. Education: 16 years. MMSE: 23.0. MoCA: 18.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.57 SUVR (profound elevated); Amyloid beta: 690.70 pg/mL (normal ); Total tau: 289.60 pg/mL (normal ); Phosphorylated tau: 28.79 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound hippocampal and entorhinal cortex atrophy, which are hallmark features of Alzheimer's disease (AD), along with mild fusiform gyrus atrophy. The MMSE (23) and MoCA (18) scores indicate cognitive impairment, while the AV45 (amyloid PET) being profoundly elevated suggests significant amyloid deposition despite normal CSF Aβ, T-tau, and P-tau. The ventricular enlargement supports neurodegeneration.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**  \n\n(Note: The discrepancy between CSF Aβ (normal) and AV45 (elevated) could suggest a technical or biological variation, but the structural and cognitive findings strongly support AD.)",
  "timestamp": "2025-07-26T13:23:07.352733"
}