{
  "ptid_time": "027_S_5083_2013-05-21",
  "img_path": "/data/qiuhui/data/adni/images/027_S_5083/2013-05-21/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 26,002 mm³, 32.5% below the reference mean. With a Z-score of -0.78 (21.8th percentile), this represents normal volume ; hippocampal volume measures 8,748 mm³, 15.7% above the reference mean. With a Z-score of 1.53 (93.8th percentile), this represents moderate enlargement; whole brain volume measures 1,113,430 mm³, 3.2% above the reference mean. With a Z-score of 0.41 (65.9th percentile), this represents normal volume ; entorhinal cortex volume measures 3,976 mm³, 3.0% below the reference mean. With a Z-score of -0.21 (41.8th percentile), this represents normal volume ; fusiform gyrus volume measures 21,814 mm³, 15.8% above the reference mean. With a Z-score of 1.35 (91.1th percentile), this represents mild enlargement; middle temporal gyrus volume measures 25,288 mm³, 18.5% above the reference mean. With a Z-score of 1.66 (95.2th percentile), this represents moderate enlargement. ",
  "text_data": "Age is 73.7 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Neurologic; Musculoskeletal; Endocrine-Metabolic; Smoking; Major Surgical Procedures. MMSE: 28.0. MoCA: 26.0. Logical Memory: 9.0. Laboratory findings: Creatine Kinase: 499.00 (profound elevated); ALT (SGPT): 36.00 (significant elevated); AST (SGOT): 54.00 (profound elevated). APOEε4 alleles: 2.0. Biomarker levels: Florbetapir (AV45): 1.08 SUVR (normal ); Amyloid beta: 1002.00 pg/mL (normal ); Total tau: 197.90 pg/mL (normal ); Phosphorylated tau: 15.92 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements show normal or above-average volumes in key regions (hippocampus, fusiform gyrus, middle temporal gyrus), with no significant atrophy. Biomarkers (Aβ, T-tau, P-tau, AV45) are normal, and cognitive scores (MMSE 28, MoCA 26) are within the normal range for age. The presence of two APOE4 alleles increases Alzheimer's risk but does not currently indicate pathology.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to APOE4 status, but current biomarkers and cognition support normal aging)",
  "timestamp": "2025-07-26T04:06:43.491142"
}