{
  "ptid_time": "127_S_4198_2011-09-01",
  "img_path": "/data/qiuhui/data/adni/images/127_S_4198/2011-09-01/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 40,868 mm³, 45.6% above the reference mean. With a Z-score of 1.04 (85.2th percentile), this represents mild enlargement; whole brain volume measures 977,791 mm³, 0.3% above the reference mean. With a Z-score of 0.04 (51.6th percentile), this represents normal volume ; entorhinal cortex volume measures 3,172 mm³, 13.6% below the reference mean. With a Z-score of -0.84 (20.1th percentile), this represents normal volume ; fusiform gyrus volume measures 17,010 mm³, 0.0% below the reference mean. With a Z-score of -0.00 (49.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,446 mm³, 6.7% above the reference mean. With a Z-score of 0.58 (71.8th percentile), this represents normal volume . ",
  "text_data": "Age is 78.4 years. Gender is Female. Education: 16 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Respiratory; Dermatologic-Connective Tissue; Musculoskeletal; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking. MMSE: 30.0. MoCA: 28.0. Logical Memory: 10.0. Laboratory findings: Calcium (EDTA): 11.30 (profound elevated). APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.40 SUVR (significant elevated); Amyloid beta: 712.20 pg/mL (normal ); Total tau: 193.50 pg/mL (normal ); Phosphorylated tau: 19.27 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The data shows mild ventricular enlargement (consistent with age-related atrophy) but otherwise normal brain volumes, including key regions like the entorhinal cortex and fusiform gyrus. Cognitive scores (MMSE 30, MoCA 28) are intact, and CSF biomarkers (Aβ, tau) are normal, though AV45 (amyloid PET) is elevated, suggesting preclinical amyloid deposition.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (Elevated AV45 raises concern for future risk, but current cognitive and structural findings do not meet criteria for MCI/dementia.)  \n\n*Note: The elevated AV45 suggests amyloid pathology, which may precede cognitive decline, but without functional impairment or neurodegeneration (normal tau, preserved volumes), this aligns with preclinical Alzheimer's changes rather than MCI/dementia.*",
  "timestamp": "2025-07-26T13:15:05.136020"
}