{
  "ptid_time": "100_S_1286_2009-03-17",
  "img_path": "/data/qiuhui/data/adni/images/100_S_1286/2009-03-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 48,476 mm³, 72.7% above the reference mean. With a Z-score of 1.66 (95.2th percentile), this represents moderate enlargement; hippocampal volume measures 8,472 mm³, 19.1% above the reference mean. With a Z-score of 1.75 (96.0th percentile), this represents moderate enlargement; whole brain volume measures 1,080,300 mm³, 10.8% above the reference mean. With a Z-score of 1.36 (91.4th percentile), this represents mild enlargement; entorhinal cortex volume measures 4,778 mm³, 30.1% above the reference mean. With a Z-score of 1.85 (96.8th percentile), this represents moderate enlargement; fusiform gyrus volume measures 15,115 mm³, 11.2% below the reference mean. With a Z-score of -1.02 (15.5th percentile), this represents mild atrophy; middle temporal gyrus volume measures 21,689 mm³, 13.1% above the reference mean. With a Z-score of 1.14 (87.3th percentile), this represents mild enlargement. ",
  "text_data": "Age is 77.5 years. Gender is Female. Education: 19 years. MMSE: 28.0. Logical Memory: 22.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows mixed findings, with some regions (ventricular, hippocampal, whole brain, entorhinal cortex, middle temporal gyrus) showing enlargement, while the fusiform gyrus shows mild atrophy. The MMSE score of 28 is within the normal range (≥26), and the absence of APOE4 reduces genetic risk. Enlargement in some regions may reflect compensatory mechanisms or individual variability rather than neurodegeneration.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to conflicting volumetric findings despite normal cognition)",
  "timestamp": "2025-07-26T11:23:18.100054"
}