{
  "ptid_time": "126_S_4675_2014-04-28",
  "img_path": "/data/qiuhui/data/adni/images/126_S_4675/2014-04-28/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 54,850 mm³, 16.7% above the reference mean. With a Z-score of 0.48 (68.6th percentile), this represents normal volume ; hippocampal volume measures 5,065 mm³, 27.3% below the reference mean. With a Z-score of -2.36 (0.9th percentile), this represents significant atrophy; whole brain volume measures 955,536 mm³, 7.2% below the reference mean. With a Z-score of -0.94 (17.4th percentile), this represents normal volume ; entorhinal cortex volume measures 2,811 mm³, 29.2% below the reference mean. With a Z-score of -1.91 (2.8th percentile), this represents moderate atrophy; fusiform gyrus volume measures 15,251 mm³, 15.6% below the reference mean. With a Z-score of -1.35 (8.9th percentile), this represents mild atrophy; middle temporal gyrus volume measures 14,769 mm³, 26.8% below the reference mean. With a Z-score of -2.40 (0.8th percentile), this represents significant atrophy. ",
  "text_data": "Age is 81.8 years. Gender is Male. Education: 12 years. MMSE: 21.0. MoCA: 19.0. Logical Memory: 5.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.66 SUVR (profound elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the hippocampus and middle temporal gyrus, along with moderate atrophy in the entorhinal cortex—key regions affected in Alzheimer’s disease. The cognitive scores (MMSE 21, MoCA 19) are below normal for age, and the presence of an APOE4 allele and elevated amyloid (AV45) further support neurodegeneration consistent with AD.  \n\n**Diagnosis:** Dementia (likely Alzheimer’s disease)  \n**Confidence:** High",
  "timestamp": "2025-07-26T12:48:50.961638"
}