{
  "ptid_time": "137_S_4520_2014-03-18",
  "img_path": "/data/qiuhui/data/adni/images/137_S_4520/2014-03-18/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 16,003 mm³, 46.7% below the reference mean. With a Z-score of -1.11 (13.4th percentile), this represents mild atrophy; hippocampal volume measures 9,478 mm³, 18.1% above the reference mean. With a Z-score of 1.81 (96.5th percentile), this represents moderate enlargement; whole brain volume measures 1,188,310 mm³, 4.7% above the reference mean. With a Z-score of 0.67 (74.9th percentile), this represents normal volume ; entorhinal cortex volume measures 4,366 mm³, 2.4% above the reference mean. With a Z-score of 0.17 (56.6th percentile), this represents normal volume ; fusiform gyrus volume measures 19,768 mm³, 0.7% below the reference mean. With a Z-score of -0.06 (47.7th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,005 mm³, 6.3% below the reference mean. With a Z-score of -0.52 (30.3th percentile), this represents normal volume . ",
  "text_data": "Age is 69.8 years. Gender is Male. Education: 16 years. MMSE: 28.0. MoCA: 27.0. Logical Memory: 12.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.00 SUVR (normal ); Total tau: 373.40 pg/mL (moderate elevated); Phosphorylated tau: 35.48 pg/mL (moderate elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows mild ventricular atrophy but otherwise normal or above-average volumes in key regions (hippocampus, whole brain, entorhinal cortex). Cognitive scores (MMSE 28, MoCA 27) are within normal range, and amyloid PET (AV45) is normal, though CSF biomarkers (elevated T-tau/P-tau) suggest some neurodegenerative activity. The absence of APOE4 and preserved cognitive function argue against dementia.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (biomarker elevations are atypical for CN but may reflect preclinical or non-AD pathology)",
  "timestamp": "2025-07-26T16:34:30.753701"
}