{
  "ptid_time": "041_S_4200_2011-09-20",
  "img_path": "/data/qiuhui/data/adni/images/041_S_4200/2011-09-20/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 18,864 mm³, 32.8% below the reference mean. With a Z-score of -0.75 (22.6th percentile), this represents normal volume ; hippocampal volume measures 8,227 mm³, 15.6% above the reference mean. With a Z-score of 1.43 (92.4th percentile), this represents mild enlargement; whole brain volume measures 1,059,270 mm³, 8.7% above the reference mean. With a Z-score of 1.09 (86.3th percentile), this represents mild enlargement; entorhinal cortex volume measures 4,056 mm³, 10.4% above the reference mean. With a Z-score of 0.64 (73.9th percentile), this represents normal volume ; fusiform gyrus volume measures 16,269 mm³, 4.4% below the reference mean. With a Z-score of -0.40 (34.5th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,422 mm³, 17.0% above the reference mean. With a Z-score of 1.47 (93.0th percentile), this represents mild enlargement. ",
  "text_data": "Age is 70.2 years. Gender is Female. Education: 18 years. Handedness: Left. Race: White. Medical history: Psychiatric; Endocrine-Metabolic; Gastrointestinal; Smoking; Major Surgical Procedures. MMSE: 30.0. MoCA: 29.0. Logical Memory: 14.0. Laboratory findings: Triglycerides (GPO): 480.00 (profound elevated); GGT: 63.00 (profound elevated); ALT (SGPT): 53.00 (profound elevated); AST (SGOT): 43.00 (profound elevated). APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.07 SUVR (normal ); Amyloid beta: 1544.00 pg/mL (mild elevated); Total tau: 146.50 pg/mL (mild reduced); Phosphorylated tau: 13.05 pg/mL (mild reduced). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements show no significant atrophy, with several regions (hippocampus, whole brain, middle temporal gyrus) even mildly enlarged. Cognitive scores (MMSE 30, MoCA 29) are intact, and biomarkers (Aβ mildly elevated but AV45 normal, tau reduced) do not strongly support Alzheimer’s pathology.  \n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** High",
  "timestamp": "2025-07-26T07:14:30.622484"
}