{
  "ptid_time": "094_S_2216_2013-03-07",
  "img_path": "/data/qiuhui/data/adni/images/094_S_2216/2013-03-07/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 73,540 mm³, 90.9% above the reference mean. With a Z-score of 2.18 (98.5th percentile), this represents significant enlargement; hippocampal volume measures 6,759 mm³, 10.6% below the reference mean. With a Z-score of -1.03 (15.1th percentile), this represents mild atrophy; whole brain volume measures 1,201,560 mm³, 11.3% above the reference mean. With a Z-score of 1.47 (92.9th percentile), this represents mild enlargement; entorhinal cortex volume measures 4,687 mm³, 14.3% above the reference mean. With a Z-score of 0.97 (83.4th percentile), this represents normal volume ; fusiform gyrus volume measures 16,073 mm³, 14.7% below the reference mean. With a Z-score of -1.25 (10.6th percentile), this represents mild atrophy; middle temporal gyrus volume measures 18,185 mm³, 14.8% below the reference mean. With a Z-score of -1.33 (9.2th percentile), this represents mild atrophy. ",
  "text_data": "Age is 70.1 years. Gender is Male. Education: 14 years. MMSE: 25.0. MoCA: 16.0. Logical Memory: 4.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.36 SUVR (significant elevated); Amyloid beta: 531.30 pg/mL (mild reduced); Total tau: 325.50 pg/mL (mild elevated); Phosphorylated tau: 32.65 pg/mL (mild elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging shows significant ventricular enlargement (consistent with atrophy) and mild hippocampal atrophy, along with atrophy in the fusiform gyrus and middle temporal gyrus—regions critical for memory and cognition. The MoCA score of 16 (well below the typical cutoff of 26) indicates substantial cognitive impairment, while biomarkers (elevated AV45, Aβ reduction, and tau) support Alzheimer's pathology.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease)  \n**Confidence:** **High**  \n\n*(Key findings: Structural atrophy in AD-vulnerable regions, strongly abnormal MoCA, and biomarker evidence of amyloid/tau pathology.)*",
  "timestamp": "2025-07-26T10:26:20.240045"
}