{
  "ptid_time": "033_S_4177_2013-09-11",
  "img_path": "/data/qiuhui/data/adni/images/033_S_4177/2013-09-11/t1.nii.gz",
  "img_finding": "Image findings: hippocampal volume measures 8,756 mm³, 25.7% above the reference mean. With a Z-score of 2.22 (98.7th percentile), this represents significant enlargement; whole brain volume measures 1,127,320 mm³, 9.5% above the reference mean. With a Z-score of 1.25 (89.4th percentile), this represents mild enlargement; entorhinal cortex volume measures 4,523 mm³, 14.0% above the reference mean. With a Z-score of 0.91 (82.0th percentile), this represents normal volume ; fusiform gyrus volume measures 16,440 mm³, 9.0% below the reference mean. With a Z-score of -0.78 (21.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 23,795 mm³, 18.0% above the reference mean. With a Z-score of 1.61 (94.6th percentile), this represents moderate enlargement. ",
  "text_data": "Age is 86.9 years. Gender is Male. Education: 20 years. MMSE: 30.0. MoCA: 24.0. Logical Memory: 21.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.07 SUVR (normal ); Amyloid beta: 957.70 pg/mL (normal ); Total tau: 188.00 pg/mL (normal ); Phosphorylated tau: 16.01 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal, whole brain, and middle temporal gyrus volumes are significantly or moderately enlarged, while other regions are within normal ranges. Cognitive testing shows a perfect MMSE but a slightly reduced MoCA (24/30), though biomarkers (Aβ, tau, AV45) are normal. The absence of APOE4 and normal biomarkers suggest low Alzheimer's risk.  \n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (MoCA is borderline, but structural and biomarker data strongly favor normal cognition)",
  "timestamp": "2025-07-26T05:36:19.881190"
}