{
  "ptid_time": "137_S_4482_2014-03-17",
  "img_path": "/data/qiuhui/data/adni/images/137_S_4482/2014-03-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 18,023 mm³, 35.8% below the reference mean. With a Z-score of -0.82 (20.6th percentile), this represents normal volume ; hippocampal volume measures 7,473 mm³, 5.0% above the reference mean. With a Z-score of 0.46 (67.8th percentile), this represents normal volume ; whole brain volume measures 937,750 mm³, 3.8% below the reference mean. With a Z-score of -0.48 (31.7th percentile), this represents normal volume ; entorhinal cortex volume measures 3,251 mm³, 11.5% below the reference mean. With a Z-score of -0.71 (24.0th percentile), this represents normal volume ; fusiform gyrus volume measures 16,770 mm³, 1.4% below the reference mean. With a Z-score of -0.13 (44.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,319 mm³, 0.8% above the reference mean. With a Z-score of 0.07 (52.7th percentile), this represents normal volume . ",
  "text_data": "Age is 79.2 years. Gender is Female. Education: 16 years. MMSE: 30.0. MoCA: 24.0. Logical Memory: 15.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.58 SUVR (profound elevated); Amyloid beta: 1089.00 pg/mL (normal ); Total tau: 631.80 pg/mL (profound elevated); Phosphorylated tau: 68.18 pg/mL (profound elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "Reasoning: The brain volumes are within normal ranges, with no significant atrophy in key regions like the hippocampus or entorhinal cortex. However, the presence of profoundly elevated T-tau, P-tau, and AV45 (amyloid) biomarkers suggests Alzheimer's pathology, despite normal Aβ levels and intact cognitive performance (MMSE 30, MoCA 24).  \n\nDiagnosis: **CN (Cognitively Normal)**  \nConfidence: **Medium** (Biomarkers indicate pathology, but cognitive scores and brain volumes remain normal, suggesting preclinical AD or a non-AD tauopathy.)  \n\n*Note: The discrepancy between normal Aβ and elevated tau/AV45 is unusual for typical AD and may warrant further investigation (e.g., primary age-related tauopathy [PART] or another neurodegenerative process).*",
  "timestamp": "2025-07-26T16:33:29.638474"
}