{
  "ptid_time": "007_S_4516_2012-02-13",
  "img_path": "/data/qiuhui/data/adni/images/007_S_4516/2012-02-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 31,848 mm³, 17.3% below the reference mean. With a Z-score of -0.41 (33.9th percentile), this represents normal volume ; hippocampal volume measures 7,944 mm³, 5.1% above the reference mean. With a Z-score of 0.50 (69.0th percentile), this represents normal volume ; whole brain volume measures 1,125,000 mm³, 4.2% above the reference mean. With a Z-score of 0.55 (70.8th percentile), this represents normal volume ; entorhinal cortex volume measures 4,133 mm³, 0.8% above the reference mean. With a Z-score of 0.05 (52.1th percentile), this represents normal volume ; fusiform gyrus volume measures 23,857 mm³, 26.6% above the reference mean. With a Z-score of 2.27 (98.8th percentile), this represents significant enlargement; middle temporal gyrus volume measures 23,995 mm³, 12.4% above the reference mean. With a Z-score of 1.12 (86.8th percentile), this represents mild enlargement. ",
  "text_data": "Age is 71.4 years. Gender is Male. Education: 20 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Smoking; Major Surgical Procedures. MMSE: 28.0. MoCA: 27.0. Logical Memory: 15.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.02 SUVR (normal ); Amyloid beta: 1488.00 pg/mL (mild elevated); Total tau: 232.50 pg/mL (normal ); Phosphorylated tau: 19.91 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements (hippocampus, entorhinal cortex, whole brain) are within normal ranges, and key biomarkers (Aβ mildly elevated but T-tau/P-tau normal) do not strongly suggest Alzheimer's pathology. Cognitive scores (MMSE 28, MoCA 27) are intact, and APOE4-negative status further reduces AD risk. Fusiform/middle temporal gyrus enlargement is atypical but not indicative of neurodegeneration.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to mildly elevated Aβ, though other markers and cognition are normal)",
  "timestamp": "2025-07-25T22:02:31.599097"
}