{
  "ptid_time": "023_S_1190_2007-01-08",
  "img_path": "/data/qiuhui/data/adni/images/023_S_1190/2007-01-08/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 20,442 mm³, 27.2% below the reference mean. With a Z-score of -0.62 (26.7th percentile), this represents normal volume ; hippocampal volume measures 7,905 mm³, 11.1% above the reference mean. With a Z-score of 1.02 (84.6th percentile), this represents mild enlargement; whole brain volume measures 989,390 mm³, 1.5% above the reference mean. With a Z-score of 0.19 (57.5th percentile), this represents normal volume ; entorhinal cortex volume measures 4,071 mm³, 10.8% above the reference mean. With a Z-score of 0.67 (74.7th percentile), this represents normal volume ; fusiform gyrus volume measures 16,619 mm³, 2.3% below the reference mean. With a Z-score of -0.21 (41.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,077 mm³, 4.7% above the reference mean. With a Z-score of 0.41 (65.9th percentile), this represents normal volume . ",
  "text_data": "Age is 76.5 years. Gender is Female. Education: 13 years. MMSE: 30.0. Logical Memory: 18.0. APOEε4 alleles: 0.0. Biomarker levels: Total tau: 370.90 pg/mL (moderate elevated); Phosphorylated tau: 33.74 pg/mL (moderate elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are largely within normal ranges, with no significant atrophy in key regions like the hippocampus or entorhinal cortex. The MMSE score of 30 is intact, but the moderate elevation in T-tau and P-tau suggests possible underlying neurodegenerative pathology despite normal structural imaging.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (due to conflicting biomarkers—normal imaging and cognition but elevated tau, which may indicate preclinical changes)",
  "timestamp": "2025-07-26T02:55:10.079384"
}