{
  "ptid_time": "051_S_4929_2012-09-18",
  "img_path": "/data/qiuhui/data/adni/images/051_S_4929/2012-09-18/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 49,948 mm³, 78.0% above the reference mean. With a Z-score of 1.79 (96.3th percentile), this represents moderate enlargement; hippocampal volume measures 4,893 mm³, 31.2% below the reference mean. With a Z-score of -2.86 (0.2th percentile), this represents significant atrophy; whole brain volume measures 854,411 mm³, 12.3% below the reference mean. With a Z-score of -1.55 (6.0th percentile), this represents moderate atrophy; entorhinal cortex volume measures 2,683 mm³, 27.0% below the reference mean. With a Z-score of -1.65 (4.9th percentile), this represents moderate atrophy; fusiform gyrus volume measures 10,309 mm³, 39.4% below the reference mean. With a Z-score of -3.59 (0.0th percentile), this represents profound atrophy; middle temporal gyrus volume measures 15,670 mm³, 18.3% below the reference mean. With a Z-score of -1.58 (5.7th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 75.7 years. Gender is Female. Education: 15 years. Handedness: Right. Race: White. Medical history: Musculoskeletal. MMSE: 25.0. MoCA: 17.0. Logical Memory: 3.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.33 SUVR (moderate elevated); Amyloid beta: 563.20 pg/mL (mild reduced); Total tau: 415.80 pg/mL (significant elevated); Phosphorylated tau: 45.24 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in key Alzheimer's-related regions (hippocampus, fusiform gyrus, entorhinal cortex) alongside elevated biomarkers (Aβ, T-tau, P-tau, AV45). The cognitive scores (MMSE 25, MoCA 17) indicate notable impairment, particularly in executive function (MoCA <26 is abnormal). The APOE4 carrier status further supports Alzheimer's pathology.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease)  \n**Confidence:** **High** (consistent structural, biomarker, and clinical evidence)",
  "timestamp": "2025-07-26T07:37:17.369777"
}