{
  "ptid_time": "941_S_4100_2011-10-03",
  "img_path": "/data/qiuhui/data/adni/images/941_S_4100/2011-10-03/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 57,649 mm³, 105.4% above the reference mean. With a Z-score of 2.41 (99.2th percentile), this represents significant enlargement; hippocampal volume measures 7,187 mm³, 1.0% above the reference mean. With a Z-score of 0.09 (53.7th percentile), this represents normal volume ; whole brain volume measures 1,044,910 mm³, 7.2% above the reference mean. With a Z-score of 0.91 (81.8th percentile), this represents normal volume ; entorhinal cortex volume measures 3,245 mm³, 11.7% below the reference mean. With a Z-score of -0.72 (23.7th percentile), this represents normal volume ; fusiform gyrus volume measures 19,459 mm³, 14.4% above the reference mean. With a Z-score of 1.31 (90.5th percentile), this represents mild enlargement; middle temporal gyrus volume measures 21,464 mm³, 12.0% above the reference mean. With a Z-score of 1.04 (85.1th percentile), this represents mild enlargement. ",
  "text_data": "Age is 78.5 years. Gender is Female. Education: 12 years. Handedness: Left. Race: White. Medical history: Cardiovascular; Endocrine-Metabolic; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking. MMSE: 28.0. MoCA: 27.0. Logical Memory: 14.0. Laboratory findings: . APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.34 SUVR (significant elevated); Amyloid beta: 889.90 pg/mL (normal ); Total tau: 300.20 pg/mL (normal ); Phosphorylated tau: 28.58 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (Z-score 2.41), which is a marker of brain atrophy, but hippocampal volume is normal (Z-score 0.09). Cognitive scores (MMSE 28, MoCA 27) are within normal limits, and CSF biomarkers (Aβ, T-tau, P-tau) are normal despite elevated AV45 (amyloid PET). The entorhinal cortex is slightly reduced but still within normal range.  \n\n**Diagnosis:** **Cognitively Normal (CN)**  \n**Confidence:** **Medium** (due to conflicting findings—ventricular enlargement suggests some neurodegeneration, but cognitive and biomarker profiles do not support MCI or dementia).",
  "timestamp": "2025-07-26T17:34:04.161948"
}