{
  "ptid_time": "131_S_0441_2007-06-14",
  "img_path": "/data/qiuhui/data/adni/images/131_S_0441/2007-06-14/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 28,489 mm³, 1.5% above the reference mean. With a Z-score of 0.03 (51.4th percentile), this represents normal volume ; hippocampal volume measures 6,927 mm³, 2.6% below the reference mean. With a Z-score of -0.24 (40.4th percentile), this represents normal volume ; whole brain volume measures 974,644 mm³, 0.0% below the reference mean. With a Z-score of -0.00 (50.0th percentile), this represents normal volume ; entorhinal cortex volume measures 2,924 mm³, 20.4% below the reference mean. With a Z-score of -1.25 (10.5th percentile), this represents mild atrophy; fusiform gyrus volume measures 17,689 mm³, 4.0% above the reference mean. With a Z-score of 0.36 (64.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 16,643 mm³, 13.2% below the reference mean. With a Z-score of -1.14 (12.6th percentile), this represents mild atrophy. ",
  "text_data": "Age is 73.7 years. Gender is Female. Education: 16 years. MMSE: 30.0. Logical Memory: 15.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 1618.00 pg/mL (moderate elevated); Total tau: 255.40 pg/mL (normal ); Phosphorylated tau: 22.35 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The entorhinal cortex and middle temporal gyrus show mild atrophy, which is concerning for early neurodegenerative changes. However, hippocampal and whole-brain volumes are normal, MMSE is intact (30/30), and CSF biomarkers (normal T-tau and P-tau) do not strongly support Alzheimer’s pathology despite moderate Aβ elevation.  \n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (Atrophy in key regions raises suspicion, but normal cognition and non-AD biomarker profile suggest no current impairment.)  \n\n*Note: Given the Aβ elevation, this individual may be at risk for future decline, but current data do not meet criteria for MCI or dementia.*",
  "timestamp": "2025-07-26T15:05:58.619024"
}