{
  "ptid_time": "021_S_5236_2017-07-27",
  "img_path": "/data/qiuhui/data/adni/images/021_S_5236/2017-07-27/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 31,843 mm³, 32.3% below the reference mean. With a Z-score of -0.94 (17.4th percentile), this represents normal volume ; hippocampal volume measures 6,850 mm³, 1.7% below the reference mean. With a Z-score of -0.15 (44.2th percentile), this represents normal volume ; whole brain volume measures 1,042,100 mm³, 1.3% above the reference mean. With a Z-score of 0.16 (56.5th percentile), this represents normal volume ; entorhinal cortex volume measures 2,782 mm³, 29.9% below the reference mean. With a Z-score of -1.96 (2.5th percentile), this represents moderate atrophy; fusiform gyrus volume measures 17,506 mm³, 3.1% below the reference mean. With a Z-score of -0.27 (39.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,271 mm³, 0.5% above the reference mean. With a Z-score of 0.04 (51.8th percentile), this represents normal volume . ",
  "text_data": "Age is 89.3 years. Gender is Male. Education: 16 years. MMSE: 29.0. MoCA: 25.0. Logical Memory: 12.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.07 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "Reasoning: The entorhinal cortex shows moderate atrophy (Z-score -1.96, 2.5th percentile), which is a strong biomarker for Alzheimer's pathology. However, other brain volumes (hippocampus, whole brain, fusiform gyrus, middle temporal gyrus) are within normal ranges, and cognitive scores (MMSE 29, MoCA 25) are near-normal for age. The absence of APOE4 and normal AV45 (amyloid PET) further reduce the likelihood of Alzheimer's.  \n\nDiagnosis: CN (Cognitively Normal)  \nConfidence: Medium (due to conflicting evidence—entorhinal atrophy is concerning, but other markers and cognitive scores suggest stability)",
  "timestamp": "2025-07-26T01:55:40.277258"
}