{
  "ptid_time": "021_S_0626_2017-04-12",
  "img_path": "/data/qiuhui/data/adni/images/021_S_0626/2017-04-12/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 50,309 mm³, 2.9% above the reference mean. With a Z-score of 0.26 (60.4th percentile), this represents normal volume ; hippocampal volume measures 5,338 mm³, 16.2% below the reference mean. With a Z-score of -1.76 (3.9th percentile), this represents moderate atrophy; whole brain volume measures 979,561 mm³, 2.2% below the reference mean. With a Z-score of -0.38 (35.3th percentile), this represents normal volume ; entorhinal cortex volume measures 2,856 mm³, 27.8% below the reference mean. With a Z-score of -1.43 (7.7th percentile), this represents mild atrophy; fusiform gyrus volume measures 13,892 mm³, 17.6% below the reference mean. With a Z-score of -2.03 (2.1th percentile), this represents significant atrophy; middle temporal gyrus volume measures 13,737 mm³, 27.1% below the reference mean. With a Z-score of -4.17 (0.0th percentile), this represents profound atrophy. ",
  "text_data": "Age is 93.7 years. Gender is Male. Education: 16 years. MMSE: 18.0. MoCA: 15.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.61 SUVR (profound elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in key Alzheimer's-related regions (hippocampus, entorhinal cortex, fusiform gyrus, and profound atrophy in the middle temporal gyrus), alongside cognitive scores (MMSE 18, MoCA 15) well below normal thresholds for age. The absence of APOE4 does not rule out Alzheimer's, and the elevated AV45 (amyloid PET) supports amyloid pathology.  \n**Diagnosis:** **Dementia** (likely Alzheimer’s disease given the pattern of atrophy and amyloid positivity).  \n**Confidence:** **High** (structural and functional deficits align strongly with neurodegenerative dementia).",
  "timestamp": "2025-07-26T01:33:26.102648"
}