{
  "ptid_time": "003_S_4119_2011-08-09",
  "img_path": "/data/qiuhui/data/adni/images/003_S_4119/2011-08-09/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 38,806 mm³, 0.7% above the reference mean. With a Z-score of 0.02 (50.7th percentile), this represents normal volume ; hippocampal volume measures 7,274 mm³, 3.8% below the reference mean. With a Z-score of -0.37 (35.6th percentile), this represents normal volume ; whole brain volume measures 1,115,140 mm³, 3.3% above the reference mean. With a Z-score of 0.43 (66.6th percentile), this represents normal volume ; entorhinal cortex volume measures 4,204 mm³, 2.5% above the reference mean. With a Z-score of 0.17 (56.8th percentile), this represents normal volume ; fusiform gyrus volume measures 22,128 mm³, 17.5% above the reference mean. With a Z-score of 1.49 (93.2th percentile), this represents mild enlargement; middle temporal gyrus volume measures 21,497 mm³, 0.7% above the reference mean. With a Z-score of 0.07 (52.7th percentile), this represents normal volume . ",
  "text_data": "Age is 79.3 years. Gender is Male. Education: 20 years. Handedness: Right. Race: White. Medical history: Cardiovascular; Hepatic; Dermatologic-Connective Tissue; Endocrine-Metabolic; Major Surgical Procedures. MMSE: 30.0. MoCA: 27.0. Logical Memory: 13.0. Laboratory findings: Vitamin B12: 910.00 (significant elevated); MCHC: 36.00 (significant elevated). APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.00 SUVR (normal ); Total tau: 305.60 pg/mL (normal ); Phosphorylated tau: 30.31 pg/mL (mild elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are largely within normal ranges, with only mild deviations (e.g., slightly reduced hippocampal volume but still within normal Z-score limits). Cognitive scores (MMSE 30, MoCA 27) are intact, and amyloid PET (AV45) is normal, though P-tau is mildly elevated. No significant structural or biomarker evidence of neurodegeneration.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to mild P-tau elevation, but no other supporting evidence of pathology)",
  "timestamp": "2025-07-25T20:49:24.579251"
}