{
  "ptid_time": "013_S_4580_2012-04-05",
  "img_path": "/data/qiuhui/data/adni/images/013_S_4580/2012-04-05/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 16,664 mm³, 25.4% below the reference mean. With a Z-score of -0.64 (26.3th percentile), this represents normal volume ; hippocampal volume measures 7,936 mm³, 3.3% above the reference mean. With a Z-score of 0.37 (64.3th percentile), this represents normal volume ; whole brain volume measures 976,816 mm³, 5.1% below the reference mean. With a Z-score of -0.63 (26.3th percentile), this represents normal volume ; entorhinal cortex volume measures 3,121 mm³, 19.8% below the reference mean. With a Z-score of -1.54 (6.2th percentile), this represents moderate atrophy; fusiform gyrus volume measures 16,609 mm³, 8.8% below the reference mean. With a Z-score of -0.99 (16.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,426 mm³, 15.1% below the reference mean. With a Z-score of -1.34 (9.0th percentile), this represents mild atrophy. ",
  "text_data": "Age is 69.7 years. Gender is Female. Education: 16 years. Handedness: Right. Race: White. Medical history: Psychiatric; Cardiovascular; Major Surgical Procedures. MMSE: 30.0. MoCA: 27.0. Logical Memory: 13.0. APOEε4 alleles: 2.0. Biomarker levels: Florbetapir (AV45): 1.03 SUVR (normal ); Amyloid beta: 857.00 pg/mL (normal ); Total tau: 281.30 pg/mL (normal ); Phosphorylated tau: 25.42 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume analysis shows normal ventricular, hippocampal, whole brain, and fusiform gyrus volumes, with only mild to moderate atrophy in the entorhinal cortex and middle temporal gyrus. Cognitive testing (MMSE 30, MoCA 27) is within normal limits, and biomarkers (Aβ, T-tau, P-tau, AV45) are normal despite APOE4 homozygosity.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (due to APOE4 risk and mild atrophy in key regions, but normal cognition and biomarkers suggest no current impairment)",
  "timestamp": "2025-07-25T23:32:43.312676"
}