{
  "ptid_time": "007_S_4488_2012-04-30",
  "img_path": "/data/qiuhui/data/adni/images/007_S_4488/2012-04-30/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 23,867 mm³, 38.0% below the reference mean. With a Z-score of -0.91 (18.1th percentile), this represents normal volume ; hippocampal volume measures 9,252 mm³, 22.4% above the reference mean. With a Z-score of 2.18 (98.6th percentile), this represents significant enlargement; whole brain volume measures 1,190,660 mm³, 10.3% above the reference mean. With a Z-score of 1.34 (91.0th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,798 mm³, 7.4% below the reference mean. With a Z-score of -0.50 (30.8th percentile), this represents normal volume ; fusiform gyrus volume measures 19,476 mm³, 3.4% above the reference mean. With a Z-score of 0.29 (61.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,688 mm³, 7.7% below the reference mean. With a Z-score of -0.70 (24.3th percentile), this represents normal volume . ",
  "text_data": "Age is 72.6 years. Gender is Male. Education: 18 years. Handedness: Right. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Dermatologic-Connective Tissue; Musculoskeletal; Gastrointestinal; Renal-Genitourinary; Smoking; Major Surgical Procedures. MMSE: 30.0. Logical Memory: 16.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.02 SUVR (normal ); Amyloid beta: 1641.00 pg/mL (moderate elevated); Total tau: 200.20 pg/mL (normal ); Phosphorylated tau: 16.28 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows normal or enlarged volumes in most regions, including the hippocampus and whole brain, with only mild reductions in the entorhinal cortex and middle temporal gyrus. The MMSE score is intact (30/30), and while Aβ is moderately elevated, tau biomarkers (T-tau, P-tau) and AV45 (amyloid PET) are normal, suggesting no strong evidence of neurodegeneration.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (due to moderately elevated Aβ, but otherwise normal clinical and structural findings)",
  "timestamp": "2025-07-25T22:01:33.109910"
}