{
  "ptid_time": "011_S_4105_2015-07-29",
  "img_path": "/data/qiuhui/data/adni/images/011_S_4105/2015-07-29/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 63,594 mm³, 126.6% above the reference mean. With a Z-score of 2.90 (99.8th percentile), this represents significant enlargement; hippocampal volume measures 6,815 mm³, 4.2% below the reference mean. With a Z-score of -0.39 (35.0th percentile), this represents normal volume ; whole brain volume measures 966,311 mm³, 0.9% below the reference mean. With a Z-score of -0.11 (45.7th percentile), this represents normal volume ; entorhinal cortex volume measures 2,886 mm³, 21.4% below the reference mean. With a Z-score of -1.32 (9.4th percentile), this represents mild atrophy; fusiform gyrus volume measures 14,206 mm³, 16.5% below the reference mean. With a Z-score of -1.50 (6.7th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 18,555 mm³, 3.2% below the reference mean. With a Z-score of -0.28 (39.0th percentile), this represents normal volume . ",
  "text_data": "Age is 74.8 years. Gender is Female. Education: 18 years. MMSE: 30.0. MoCA: 26.0. Logical Memory: 13.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.04 SUVR (normal ); Amyloid beta: 1142.00 pg/mL (normal ); Total tau: 144.10 pg/mL (mild reduced); Phosphorylated tau: 11.88 pg/mL (mild reduced). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant ventricular enlargement (consistent with atrophy) and mild-to-moderate atrophy in the entorhinal cortex and fusiform gyrus, which are regions vulnerable to Alzheimer's pathology. However, cognitive scores (MMSE 30, MoCA 26) are within normal limits, and biomarkers (Aβ normal, tau reduced) do not support active Alzheimer’s pathology.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (Structural changes suggest early neurodegeneration, but cognitive and biomarker profiles do not yet meet criteria for MCI or dementia. Monitoring for progression is warranted.)",
  "timestamp": "2025-07-25T22:54:03.773808"
}