{
  "ptid_time": "067_S_0056_2005-11-09",
  "img_path": "/data/qiuhui/data/adni/images/067_S_0056/2005-11-09/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 13,272 mm³, 40.6% below the reference mean. With a Z-score of -1.02 (15.5th percentile), this represents mild atrophy; hippocampal volume measures 7,606 mm³, 1.0% below the reference mean. With a Z-score of -0.11 (45.4th percentile), this represents normal volume ; whole brain volume measures 930,513 mm³, 9.6% below the reference mean. With a Z-score of -1.19 (11.6th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,796 mm³, 28.2% below the reference mean. With a Z-score of -2.18 (1.5th percentile), this represents significant atrophy; fusiform gyrus volume measures 17,161 mm³, 5.8% below the reference mean. With a Z-score of -0.65 (25.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 14,746 mm³, 28.1% below the reference mean. With a Z-score of -2.50 (0.6th percentile), this represents significant atrophy. ",
  "text_data": "Age is 69.6 years. Gender is Female. Education: 13 years. Handedness: Right. Race: Black or African American. Medical history: Psychiatric; Cardiovascular; Gastrointestinal; Major Surgical Procedures. MMSE: 28.0. Logical Memory: 6.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 1048.00 pg/mL (normal ); Total tau: 128.20 pg/mL (mild reduced); Phosphorylated tau: 12.23 pg/mL (mild reduced). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant atrophy in the entorhinal cortex and middle temporal gyrus, which are key regions affected in Alzheimer's disease, alongside mild whole-brain and ventricular atrophy. However, hippocampal volume is normal, Aβ is normal, and tau levels are mildly reduced, which is atypical for Alzheimer's. The MMSE score of 28 is within the normal range, suggesting preserved cognitive function.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (due to conflicting biomarkers—structural atrophy in AD-vulnerable regions but normal Aβ and cognitive scores)",
  "timestamp": "2025-07-26T08:22:13.590157"
}