{
  "ptid_time": "002_S_4799_2014-07-03",
  "img_path": "/data/qiuhui/data/adni/images/002_S_4799/2014-07-03/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 37,861 mm³, 1.7% below the reference mean. With a Z-score of -0.04 (48.4th percentile), this represents normal volume ; hippocampal volume measures 8,062 mm³, 6.7% above the reference mean. With a Z-score of 0.65 (74.2th percentile), this represents normal volume ; whole brain volume measures 1,186,350 mm³, 9.9% above the reference mean. With a Z-score of 1.29 (90.1th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,469 mm³, 15.4% below the reference mean. With a Z-score of -1.04 (14.8th percentile), this represents mild atrophy; fusiform gyrus volume measures 21,946 mm³, 16.5% above the reference mean. With a Z-score of 1.41 (92.0th percentile), this represents mild enlargement; middle temporal gyrus volume measures 24,655 mm³, 15.5% above the reference mean. With a Z-score of 1.40 (91.9th percentile), this represents mild enlargement. ",
  "text_data": "Age is 70.0 years. Gender is Male. Education: 14 years. MMSE: 30.0. MoCA: 27.0. Logical Memory: 11.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.38 SUVR (significant elevated); Amyloid beta: 716.70 pg/mL (normal ); Total tau: 243.70 pg/mL (normal ); Phosphorylated tau: 23.19 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows mild atrophy in the entorhinal cortex (Z-score -1.04, 14.8th percentile), which is an early marker of Alzheimer's pathology, but other regions (hippocampus, whole brain, fusiform gyrus, middle temporal gyrus) are normal or enlarged. Cognitive scores (MMSE 30, MoCA 27) are within normal limits, and CSF biomarkers (Aβ, T-tau, P-tau) are normal despite elevated AV45 (amyloid PET), suggesting possible early amyloid deposition without significant neurodegeneration or cognitive impairment.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (due to conflicting findings—entorhinal atrophy vs. preserved cognition and mostly normal biomarkers)",
  "timestamp": "2025-07-25T20:32:12.667987"
}