{
  "ptid_time": "018_S_2180_2015-01-08",
  "img_path": "/data/qiuhui/data/adni/images/018_S_2180/2015-01-08/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 21,063 mm³, 43.0% below the reference mean. With a Z-score of -1.16 (12.3th percentile), this represents mild atrophy; hippocampal volume measures 7,171 mm³, 10.4% above the reference mean. With a Z-score of 0.83 (79.8th percentile), this represents normal volume ; whole brain volume measures 932,163 mm³, 0.4% above the reference mean. With a Z-score of 0.05 (52.1th percentile), this represents normal volume ; entorhinal cortex volume measures 4,635 mm³, 33.9% above the reference mean. With a Z-score of 1.83 (96.6th percentile), this represents moderate enlargement; fusiform gyrus volume measures 16,019 mm³, 0.6% below the reference mean. With a Z-score of -0.04 (48.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,517 mm³, 2.7% above the reference mean. With a Z-score of 0.24 (59.5th percentile), this represents normal volume . ",
  "text_data": "Age is 81.6 years. Gender is Female. Education: 12 years. MMSE: 28.0. MoCA: 24.0. Logical Memory: 5.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.06 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain imaging shows mild ventricular atrophy but otherwise normal or even enlarged volumes in key regions (hippocampus, entorhinal cortex). Cognitive scores (MMSE 28, MoCA 24) are borderline for MCI but not dementia, and amyloid PET (AV45) is normal. APOE4-negative status further reduces Alzheimer’s risk.  \n\n**Diagnosis:** **Cognitively Normal (CN)**  \n**Confidence:** **Medium** (MoCA 24 raises mild concern, but imaging/biomarkers suggest no neurodegeneration).",
  "timestamp": "2025-07-26T00:55:29.660664"
}