{
  "ptid_time": "127_S_5056_2013-01-03",
  "img_path": "/data/qiuhui/data/adni/images/127_S_5056/2013-01-03/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 50,326 mm³, 7.0% above the reference mean. With a Z-score of 0.20 (58.1th percentile), this represents normal volume ; hippocampal volume measures 6,262 mm³, 10.1% below the reference mean. With a Z-score of -0.88 (19.1th percentile), this represents normal volume ; whole brain volume measures 962,748 mm³, 6.5% below the reference mean. With a Z-score of -0.85 (19.9th percentile), this represents normal volume ; entorhinal cortex volume measures 2,461 mm³, 38.0% below the reference mean. With a Z-score of -2.49 (0.6th percentile), this represents significant atrophy; fusiform gyrus volume measures 14,705 mm³, 18.6% below the reference mean. With a Z-score of -1.61 (5.4th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 16,518 mm³, 18.1% below the reference mean. With a Z-score of -1.62 (5.2th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 85.3 years. Gender is Male. Education: 20 years. MMSE: 20.0. MoCA: 13.0. Logical Memory: 1.0. Laboratory findings: . APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.54 SUVR (profound elevated). ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The patient shows significant atrophy in the entorhinal cortex (Z-score -2.49) and moderate atrophy in the fusiform gyrus and middle temporal gyrus, regions critical for memory and cognition. Combined with profoundly elevated AV45 (amyloid PET) and low MMSE (20) and MoCA (13) scores, this strongly suggests neurodegenerative disease.  \n\n**Diagnosis:** **Dementia** (likely Alzheimer’s disease given amyloid positivity and medial temporal atrophy).  \n\n**Confidence:** **High** (due to concordant structural atrophy, amyloid positivity, and low cognitive scores).",
  "timestamp": "2025-07-26T13:24:33.579185"
}