{
  "ptid_time": "024_S_4084_2015-08-06",
  "img_path": "/data/qiuhui/data/adni/images/024_S_4084/2015-08-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 13,457 mm³, 52.1% below the reference mean. With a Z-score of -1.19 (11.7th percentile), this represents mild atrophy; hippocampal volume measures 8,685 mm³, 22.1% above the reference mean. With a Z-score of 2.02 (97.9th percentile), this represents significant enlargement; whole brain volume measures 1,084,720 mm³, 11.3% above the reference mean. With a Z-score of 1.42 (92.2th percentile), this represents mild enlargement; entorhinal cortex volume measures 4,450 mm³, 21.2% above the reference mean. With a Z-score of 1.30 (90.3th percentile), this represents mild enlargement; fusiform gyrus volume measures 18,244 mm³, 7.2% above the reference mean. With a Z-score of 0.66 (74.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 23,629 mm³, 23.3% above the reference mean. With a Z-score of 2.02 (97.8th percentile), this represents significant enlargement. ",
  "text_data": "Age is 72.4 years. Gender is Female. Education: 18 years. MMSE: 30.0. MoCA: 28.0. Logical Memory: 17.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.98 SUVR (normal ); Total tau: 231.40 pg/mL (normal ); Phosphorylated tau: 20.59 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows mixed findings, with mild ventricular atrophy but significant enlargement in hippocampal, whole brain, entorhinal cortex, and middle temporal gyrus volumes. Cognitive scores (MMSE 30, MoCA 28) are normal, and biomarkers (T-tau, P-tau, AV45) are unremarkable. The absence of APOE4 and normal CSF/amyloid markers further reduces Alzheimer's likelihood.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to conflicting volumetric findings despite normal cognition and biomarkers)",
  "timestamp": "2025-07-26T03:17:44.873151"
}