{
  "ptid_time": "073_S_4382_2013-12-13",
  "img_path": "/data/qiuhui/data/adni/images/073_S_4382/2013-12-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 20,557 mm³, 26.8% below the reference mean. With a Z-score of -0.61 (27.0th percentile), this represents normal volume ; hippocampal volume measures 6,936 mm³, 2.5% below the reference mean. With a Z-score of -0.23 (40.9th percentile), this represents normal volume ; whole brain volume measures 873,692 mm³, 10.4% below the reference mean. With a Z-score of -1.30 (9.6th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,656 mm³, 27.7% below the reference mean. With a Z-score of -1.70 (4.5th percentile), this represents moderate atrophy; fusiform gyrus volume measures 14,006 mm³, 17.7% below the reference mean. With a Z-score of -1.61 (5.4th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 17,218 mm³, 10.2% below the reference mean. With a Z-score of -0.88 (18.8th percentile), this represents normal volume . ",
  "text_data": "Age is 77.9 years. Gender is Female. Education: 16 years. MMSE: 30.0. MoCA: 29.0. Logical Memory: 17.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.02 SUVR (normal ); Total tau: 370.20 pg/mL (moderate elevated); Phosphorylated tau: 33.19 pg/mL (moderate elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "Reasoning: The imaging shows mild to moderate atrophy in key Alzheimer's-related regions (whole brain, entorhinal cortex, fusiform gyrus), but hippocampal volume is normal. Cognitive scores (MMSE, MoCA) are intact, and APOE4 is negative. Biomarkers (T-tau, P-tau) are moderately elevated, but amyloid (AV45) is normal, suggesting non-Alzheimer's pathology.  \nDiagnosis: CN (Cognitively Normal)  \nConfidence: Medium  \n\n(While atrophy patterns are concerning, preserved cognition and normal amyloid make dementia/MCI unlikely. However, tau elevation warrants monitoring for non-AD neurodegenerative processes.)",
  "timestamp": "2025-07-26T09:44:51.459374"
}