{
  "ptid_time": "027_S_0118_2007-02-12",
  "img_path": "/data/qiuhui/data/adni/images/027_S_0118/2007-02-12/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 38,707 mm³, 17.7% below the reference mean. With a Z-score of -0.51 (30.4th percentile), this represents normal volume ; hippocampal volume measures 5,422 mm³, 22.2% below the reference mean. With a Z-score of -1.92 (2.8th percentile), this represents moderate atrophy; whole brain volume measures 944,239 mm³, 8.3% below the reference mean. With a Z-score of -1.08 (14.0th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,574 mm³, 35.1% below the reference mean. With a Z-score of -2.30 (1.1th percentile), this represents significant atrophy; fusiform gyrus volume measures 15,976 mm³, 11.6% below the reference mean. With a Z-score of -1.00 (15.8th percentile), this represents mild atrophy; middle temporal gyrus volume measures 17,947 mm³, 11.0% below the reference mean. With a Z-score of -0.99 (16.1th percentile), this represents normal volume . ",
  "text_data": "Age is 81.4 years. Gender is Male. Education: 20 years. MMSE: 30.0. Logical Memory: 11.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 1297.00 pg/mL (normal ); Total tau: 196.20 pg/mL (normal ); Phosphorylated tau: 16.90 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "Reasoning: The patient shows significant atrophy in the hippocampus and entorhinal cortex (both below the 3rd percentile), which are key regions affected in Alzheimer's disease. However, CSF biomarkers (Aβ, T-tau, P-tau) are normal, and cognitive performance (MMSE 30) is intact, suggesting no current clinical impairment.  \nDiagnosis: **CN (Cognitively Normal)**  \nConfidence: **Medium** (Structural atrophy is concerning, but biomarkers and cognition do not yet support MCI/dementia.)  \n\n---  \n*Note: The hippocampal/entorhinal atrophy may indicate preclinical AD, but without biomarker or cognitive evidence of progression, a dementia diagnosis is premature. Monitoring is recommended.*",
  "timestamp": "2025-07-26T03:28:41.552021"
}