{
  "ptid_time": "137_S_4815_2014-08-29",
  "img_path": "/data/qiuhui/data/adni/images/137_S_4815/2014-08-29/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 16,021 mm³, 42.9% below the reference mean. With a Z-score of -0.98 (16.3th percentile), this represents normal volume ; hippocampal volume measures 4,951 mm³, 30.4% below the reference mean. With a Z-score of -2.79 (0.3th percentile), this represents significant atrophy; whole brain volume measures 924,194 mm³, 5.2% below the reference mean. With a Z-score of -0.65 (25.7th percentile), this represents normal volume ; entorhinal cortex volume measures 2,975 mm³, 19.0% below the reference mean. With a Z-score of -1.17 (12.2th percentile), this represents mild atrophy; fusiform gyrus volume measures 15,859 mm³, 6.8% below the reference mean. With a Z-score of -0.62 (26.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,251 mm³, 4.8% below the reference mean. With a Z-score of -0.42 (33.9th percentile), this represents normal volume . ",
  "text_data": "Age is 71.8 years. Gender is Female. Education: 12 years. MMSE: 24.0. MoCA: 20.0. Logical Memory: 0.0. APOEε4 alleles: 2.0. Biomarker levels: Florbetapir (AV45): 1.60 SUVR (profound elevated); Amyloid beta: 661.10 pg/mL (normal ); Total tau: 506.50 pg/mL (profound elevated); Phosphorylated tau: 55.44 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant hippocampal atrophy (Z-score -2.79, 0.3rd percentile) and mild entorhinal cortex atrophy, alongside normal ventricular and whole-brain volumes. Cognitive testing (MMSE 24, MoCA 20) indicates mild impairment, while CSF biomarkers (elevated T-tau, P-tau, and AV45) strongly suggest Alzheimer's pathology despite normal Aβ.  \n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**  \n\n*(Key findings: Hippocampal atrophy + biomarker profile [tau/Aβ mismatch] + cognitive scores align with dementia due to AD. APOE4 homozygosity further supports AD risk.)*",
  "timestamp": "2025-07-26T16:43:56.688302"
}