{
  "ptid_time": "133_S_0433_2007-05-10",
  "img_path": "/data/qiuhui/data/adni/images/133_S_0433/2007-05-10/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 21,183 mm³, 42.7% below the reference mean. With a Z-score of -1.15 (12.5th percentile), this represents mild atrophy; hippocampal volume measures 6,980 mm³, 7.5% above the reference mean. With a Z-score of 0.60 (72.5th percentile), this represents normal volume ; whole brain volume measures 847,984 mm³, 8.6% below the reference mean. With a Z-score of -1.04 (15.0th percentile), this represents mild atrophy; entorhinal cortex volume measures 2,863 mm³, 17.3% below the reference mean. With a Z-score of -0.93 (17.5th percentile), this represents normal volume ; fusiform gyrus volume measures 13,516 mm³, 16.1% below the reference mean. With a Z-score of -1.21 (11.3th percentile), this represents mild atrophy; middle temporal gyrus volume measures 18,249 mm³, 1.2% above the reference mean. With a Z-score of 0.11 (54.3th percentile), this represents normal volume . ",
  "text_data": "Age is 86.5 years. Gender is Female. Education: 14 years. MMSE: 29.0. Logical Memory: 14.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 878.00 pg/mL (normal ); Total tau: 305.60 pg/mL (normal ); Phosphorylated tau: 28.50 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging shows mild atrophy in ventricular volume, whole brain, and fusiform gyrus, but hippocampal volume is normal, and entorhinal cortex/middle temporal gyrus are within normal ranges. Biomarkers (Aβ, T-tau, P-tau) are normal, and cognitive performance (MMSE 29) is intact. Given the absence of significant biomarker abnormalities or cognitive impairment, the mild atrophy may reflect age-related changes rather than neurodegenerative disease.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to mild atrophy in some regions, but no clinical or biomarker evidence of pathology)",
  "timestamp": "2025-07-26T15:15:15.634681"
}