{
  "ptid_time": "027_S_4936_2014-09-19",
  "img_path": "/data/qiuhui/data/adni/images/027_S_4936/2014-09-19/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 38,771 mm³, 17.5% below the reference mean. With a Z-score of -0.51 (30.5th percentile), this represents normal volume ; hippocampal volume measures 7,163 mm³, 2.8% above the reference mean. With a Z-score of 0.24 (59.5th percentile), this represents normal volume ; whole brain volume measures 1,082,450 mm³, 5.2% above the reference mean. With a Z-score of 0.68 (75.1th percentile), this represents normal volume ; entorhinal cortex volume measures 3,840 mm³, 3.3% below the reference mean. With a Z-score of -0.21 (41.6th percentile), this represents normal volume ; fusiform gyrus volume measures 17,620 mm³, 2.5% below the reference mean. With a Z-score of -0.21 (41.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,967 mm³, 13.9% above the reference mean. With a Z-score of 1.24 (89.3th percentile), this represents mild enlargement. ",
  "text_data": "Age is 80.1 years. Gender is Male. Education: 19 years. MMSE: 22.0. MoCA: 13.0. Logical Memory: 0.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.36 SUVR (significant elevated); Amyloid beta: 472.30 pg/mL (mild reduced); Total tau: 195.40 pg/mL (normal ); Phosphorylated tau: 18.76 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements (hippocampus, entorhinal cortex, fusiform gyrus, etc.) are largely within normal ranges, with only mild enlargement in the middle temporal gyrus. However, cognitive testing (MMSE: 22, MoCA: 13) indicates significant impairment, and biomarker data (elevated AV45, mildly reduced Aβ) suggest amyloid pathology. The discrepancy between preserved brain volumes and cognitive decline suggests neurodegeneration may not be the primary driver of symptoms.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease given amyloid elevation, but with atypical features due to preserved volumes).  \n\n**Confidence:** **Medium** (cognitive scores strongly suggest dementia, but the lack of significant atrophy is unusual for typical AD; other contributing factors like vascular or mixed pathology may be present).",
  "timestamp": "2025-07-26T04:03:29.795450"
}