{
  "ptid_time": "127_S_0260_2006-05-01",
  "img_path": "/data/qiuhui/data/adni/images/127_S_0260/2006-05-01/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 23,196 mm³, 17.4% below the reference mean. With a Z-score of -0.40 (34.6th percentile), this represents normal volume ; hippocampal volume measures 6,221 mm³, 12.6% below the reference mean. With a Z-score of -1.15 (12.5th percentile), this represents mild atrophy; whole brain volume measures 910,755 mm³, 6.6% below the reference mean. With a Z-score of -0.83 (20.5th percentile), this represents normal volume ; entorhinal cortex volume measures 4,851 mm³, 32.1% above the reference mean. With a Z-score of 1.97 (97.6th percentile), this represents moderate enlargement; fusiform gyrus volume measures 15,677 mm³, 7.9% below the reference mean. With a Z-score of -0.71 (23.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,547 mm³, 8.5% below the reference mean. With a Z-score of -0.73 (23.1th percentile), this represents normal volume . ",
  "text_data": "Age is 78.6 years. Gender is Female. Education: 13 years. Handedness: Right. Race: White. Medical history: Musculoskeletal; Allergies or Drug Sensitivities; Malignancy; Major Surgical Procedures. MMSE: 30.0. Logical Memory: 14.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 1520.00 pg/mL (mild elevated); Total tau: 191.50 pg/mL (normal ); Phosphorylated tau: 15.47 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.15, 12.5th percentile), which is a key biomarker for Alzheimer's pathology, but other brain volumes are largely normal. The MMSE score of 30 is intact, and CSF biomarkers show only mild Aβ elevation with normal tau levels, suggesting minimal amyloid pathology without significant neurodegeneration.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (due to hippocampal atrophy but otherwise normal cognitive and biomarker profile)",
  "timestamp": "2025-07-26T12:57:54.709330"
}