{
  "ptid_time": "036_S_5271_2013-08-01",
  "img_path": "/data/qiuhui/data/adni/images/036_S_5271/2013-08-01/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 54,314 mm³, 15.5% above the reference mean. With a Z-score of 0.45 (67.4th percentile), this represents normal volume ; hippocampal volume measures 7,895 mm³, 13.3% above the reference mean. With a Z-score of 1.15 (87.5th percentile), this represents mild enlargement; whole brain volume measures 1,239,310 mm³, 20.4% above the reference mean. With a Z-score of 2.68 (99.6th percentile), this represents significant enlargement; entorhinal cortex volume measures 3,772 mm³, 5.0% below the reference mean. With a Z-score of -0.32 (37.3th percentile), this represents normal volume ; fusiform gyrus volume measures 23,273 mm³, 28.8% above the reference mean. With a Z-score of 2.50 (99.4th percentile), this represents significant enlargement; middle temporal gyrus volume measures 23,540 mm³, 16.7% above the reference mean. With a Z-score of 1.50 (93.3th percentile), this represents mild enlargement. ",
  "text_data": "Age is 80.4 years. Gender is Male. Education: 20 years. Handedness: Right. Race: White. Medical history: Psychiatric; Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Musculoskeletal; Gastrointestinal; Renal-Genitourinary; Smoking; Malignancy; Major Surgical Procedures. MMSE: 30.0. MoCA: 28.0. Logical Memory: 11.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.97 SUVR (normal ); Total tau: 314.60 pg/mL (normal ); Phosphorylated tau: 28.56 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows significant enlargement in whole brain, fusiform gyrus, and mild enlargement in hippocampal and middle temporal gyrus volumes, with normal ventricular and entorhinal cortex volumes. Cognitive scores (MMSE 30, MoCA 28) are intact, and biomarkers (T-tau, P-tau, AV45) are normal, with no APOE4 risk allele.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** High  \n\nThe absence of atrophy, normal biomarkers, and preserved cognitive function strongly suggest no neurodegenerative pathology. The enlarged volumes in some regions may reflect individual variability or compensatory mechanisms.",
  "timestamp": "2025-07-26T06:21:16.266162"
}