{
  "ptid_time": "023_S_4501_2012-03-22",
  "img_path": "/data/qiuhui/data/adni/images/023_S_4501/2012-03-22/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 38,585 mm³, 0.2% above the reference mean. With a Z-score of 0.00 (50.2th percentile), this represents normal volume ; hippocampal volume measures 4,065 mm³, 46.2% below the reference mean. With a Z-score of -4.51 (0.0th percentile), this represents profound atrophy; whole brain volume measures 974,302 mm³, 9.7% below the reference mean. With a Z-score of -1.26 (10.3th percentile), this represents mild atrophy; entorhinal cortex volume measures 1,438 mm³, 64.9% below the reference mean. With a Z-score of -4.40 (0.0th percentile), this represents profound atrophy; fusiform gyrus volume measures 16,434 mm³, 12.8% below the reference mean. With a Z-score of -1.09 (13.8th percentile), this represents mild atrophy; middle temporal gyrus volume measures 17,638 mm³, 17.3% below the reference mean. With a Z-score of -1.56 (5.9th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 79.0 years. Gender is Male. Education: 18 years. Handedness: Right. Race: White. Medical history: Renal-Genitourinary; Smoking. MMSE: 22.0. MoCA: 18.0. Logical Memory: 0.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.33 SUVR (moderate elevated); Amyloid beta: 741.50 pg/mL (normal ); Total tau: 331.50 pg/mL (mild elevated); Phosphorylated tau: 31.57 pg/mL (mild elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The data shows profound atrophy in the hippocampus and entorhinal cortex, which are key regions affected in Alzheimer's disease (AD). The MMSE (22) and MoCA (18) scores indicate cognitive impairment, while biomarker findings (elevated T-tau, P-tau, and AV45 with normal Aβ) suggest AD pathology despite the atypical Aβ profile.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **Medium** (due to the atypical Aβ profile but strong structural and biomarker support for AD)",
  "timestamp": "2025-07-26T03:06:09.834974"
}