{
  "ptid_time": "021_S_5129_2013-03-27",
  "img_path": "/data/qiuhui/data/adni/images/021_S_5129/2013-03-27/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 19,485 mm³, 30.6% below the reference mean. With a Z-score of -0.70 (24.2th percentile), this represents normal volume ; hippocampal volume measures 8,006 mm³, 12.5% above the reference mean. With a Z-score of 1.15 (87.5th percentile), this represents mild enlargement; whole brain volume measures 1,064,500 mm³, 9.2% above the reference mean. With a Z-score of 1.16 (87.7th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,691 mm³, 0.5% above the reference mean. With a Z-score of 0.03 (51.2th percentile), this represents normal volume ; fusiform gyrus volume measures 21,412 mm³, 25.9% above the reference mean. With a Z-score of 2.35 (99.1th percentile), this represents significant enlargement; middle temporal gyrus volume measures 21,927 mm³, 14.4% above the reference mean. With a Z-score of 1.25 (89.4th percentile), this represents mild enlargement. ",
  "text_data": "Age is 74.5 years. Gender is Female. Education: 16 years. Handedness: Right. Race: White. Medical history: Cardiovascular; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Malignancy; Major Surgical Procedures. MMSE: 30.0. MoCA: 28.0. Logical Memory: 14.0. Laboratory findings: Monocytes: 0.69 (significant elevated); MCHC: 36.00 (significant elevated); Monocytes: 10.90 (significant elevated); Serum Glucose: 142.00 (profound elevated). APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 0.99 SUVR (normal ); Amyloid beta: 803.10 pg/mL (normal ); Total tau: 312.30 pg/mL (normal ); Phosphorylated tau: 33.16 pg/mL (moderate elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measures show mild to significant enlargement in several regions (hippocampus, whole brain, fusiform gyrus, middle temporal gyrus), which is atypical for Alzheimer's pathology. Cognitive scores (MMSE 30, MoCA 28) are intact, and Aβ is normal, but P-tau is moderately elevated, suggesting possible early tauopathy without amyloidosis.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (P-tau elevation raises some concern, but preserved cognition and normal Aβ argue against MCI/dementia at this stage.)",
  "timestamp": "2025-07-26T01:53:26.039144"
}