{
  "ptid_time": "007_S_4488_2012-01-31",
  "img_path": "/data/qiuhui/data/adni/images/007_S_4488/2012-01-31/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 23,867 mm³, 38.0% below the reference mean. With a Z-score of -0.91 (18.1th percentile), this represents normal volume ; hippocampal volume measures 9,252 mm³, 22.4% above the reference mean. With a Z-score of 2.18 (98.6th percentile), this represents significant enlargement; whole brain volume measures 1,190,660 mm³, 10.3% above the reference mean. With a Z-score of 1.34 (91.0th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,798 mm³, 7.4% below the reference mean. With a Z-score of -0.50 (30.8th percentile), this represents normal volume ; fusiform gyrus volume measures 19,476 mm³, 3.4% above the reference mean. With a Z-score of 0.29 (61.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,688 mm³, 7.7% below the reference mean. With a Z-score of -0.70 (24.3th percentile), this represents normal volume . ",
  "text_data": "Age is 72.6 years. Gender is Male. Education: 18 years. Handedness: Right. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Dermatologic-Connective Tissue; Musculoskeletal; Gastrointestinal; Renal-Genitourinary; Smoking; Major Surgical Procedures. MMSE: 30.0. Logical Memory: 16.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.02 SUVR (normal ); Amyloid beta: 1641.00 pg/mL (moderate elevated); Total tau: 200.20 pg/mL (normal ); Phosphorylated tau: 16.28 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows normal or above-average volumes in most regions, including the hippocampus (significantly enlarged) and whole brain (mildly enlarged). The entorhinal cortex and middle temporal gyrus are slightly below the reference mean but still within normal ranges. Clinically, the patient has a perfect MMSE score (30/30), normal tau and AV45 markers, and no APOE4 risk allele, though Aβ is moderately elevated.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **High**  \n\nThe lack of significant atrophy, normal cognitive performance, and absence of key pathological markers (aside from moderately elevated Aβ, which can occur in aging without dementia) strongly suggest no cognitive impairment. The enlarged hippocampus and whole brain volume further support this conclusion.",
  "timestamp": "2025-07-25T22:01:26.638312"
}