{
  "ptid_time": "022_S_0096_2011-01-31",
  "img_path": "/data/qiuhui/data/adni/images/022_S_0096/2011-01-31/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 86,490 mm³, 84.0% above the reference mean. With a Z-score of 2.44 (99.3th percentile), this represents significant enlargement; hippocampal volume measures 7,346 mm³, 5.4% above the reference mean. With a Z-score of 0.47 (68.0th percentile), this represents normal volume ; whole brain volume measures 1,050,670 mm³, 2.1% above the reference mean. With a Z-score of 0.27 (60.8th percentile), this represents normal volume ; entorhinal cortex volume measures 2,951 mm³, 25.6% below the reference mean. With a Z-score of -1.68 (4.7th percentile), this represents moderate atrophy; fusiform gyrus volume measures 17,727 mm³, 1.9% below the reference mean. With a Z-score of -0.16 (43.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,319 mm³, 10.6% above the reference mean. With a Z-score of 0.95 (83.0th percentile), this represents normal volume . ",
  "text_data": "Age is 84.6 years. Gender is Male. Education: 20 years. Handedness: Left. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Malignancy. MMSE: 30.0. MoCA: 30.0. Logical Memory: 23.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.95 SUVR (mild reduced); Amyloid beta: 719.30 pg/mL (normal ); Total tau: 138.50 pg/mL (mild reduced); Phosphorylated tau: 12.50 pg/mL (mild reduced). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (consistent with atrophy) and moderate entorhinal cortex atrophy, both of which are associated with Alzheimer's pathology. However, cognitive scores (MMSE, MoCA) are intact, Aβ is normal, and tau markers are reduced, which argues against active neurodegeneration.  \n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (due to conflicting structural and biomarker findings despite normal cognition)",
  "timestamp": "2025-07-26T02:00:57.564491"
}