{
  "ptid_time": "082_S_5029_2012-11-14",
  "img_path": "/data/qiuhui/data/adni/images/082_S_5029/2012-11-14/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 43,741 mm³, 13.6% above the reference mean. With a Z-score of 0.32 (62.7th percentile), this represents normal volume ; hippocampal volume measures 5,601 mm³, 25.9% below the reference mean. With a Z-score of -2.53 (0.6th percentile), this represents significant atrophy; whole brain volume measures 1,164,240 mm³, 7.9% above the reference mean. With a Z-score of 1.02 (84.6th percentile), this represents mild enlargement; entorhinal cortex volume measures 2,646 mm³, 35.5% below the reference mean. With a Z-score of -2.41 (0.8th percentile), this represents significant atrophy; fusiform gyrus volume measures 19,798 mm³, 5.1% above the reference mean. With a Z-score of 0.43 (66.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,214 mm³, 10.0% below the reference mean. With a Z-score of -0.90 (18.5th percentile), this represents normal volume . ",
  "text_data": "Age is 79.6 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Hepatic; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 23.0. MoCA: 11.0. Logical Memory: 0.0. APOEε4 alleles: 2.0. Biomarker levels: Florbetapir (AV45): 1.58 SUVR (profound elevated); Amyloid beta: 277.50 pg/mL (moderate reduced); Total tau: 666.20 pg/mL (profound elevated); Phosphorylated tau: 68.07 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in the hippocampus and entorhinal cortex (both with Z-scores < -2.5), which are key regions affected in Alzheimer's disease. Combined with profoundly elevated biomarkers (Aβ reduction, elevated T-tau, P-tau, and AV45) and low cognitive scores (MMSE 23, MoCA 11), this strongly suggests neurodegenerative pathology consistent with Alzheimer's dementia.  \n\n**Diagnosis:** **Dementia (likely Alzheimer’s disease)**  \n**Confidence:** **High**",
  "timestamp": "2025-07-26T10:08:33.851301"
}