{
  "ptid_time": "003_S_5154_2018-05-02",
  "img_path": "/data/qiuhui/data/adni/images/003_S_5154/2018-05-02/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 48,991 mm³, 74.5% above the reference mean. With a Z-score of 1.71 (95.6th percentile), this represents moderate enlargement; hippocampal volume measures 7,406 mm³, 4.1% above the reference mean. With a Z-score of 0.38 (64.6th percentile), this represents normal volume ; whole brain volume measures 1,027,760 mm³, 5.4% above the reference mean. With a Z-score of 0.69 (75.4th percentile), this represents normal volume ; entorhinal cortex volume measures 5,085 mm³, 38.4% above the reference mean. With a Z-score of 2.36 (99.1th percentile), this represents significant enlargement; fusiform gyrus volume measures 19,483 mm³, 14.5% above the reference mean. With a Z-score of 1.32 (90.7th percentile), this represents mild enlargement; middle temporal gyrus volume measures 20,382 mm³, 6.3% above the reference mean. With a Z-score of 0.55 (70.9th percentile), this represents normal volume . ",
  "text_data": "Age is 77.4 years. Gender is Female. Education: 18 years. MMSE: 30.0. MoCA: 26.0. Logical Memory: 9.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.07 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The ventricular volume shows moderate enlargement (Z-score 1.71), which can indicate atrophy, but hippocampal volume is normal (Z-score 0.38). The entorhinal cortex is significantly enlarged (Z-score 2.36), which is unusual in Alzheimer’s and may suggest a different pathology. Cognitive scores (MMSE 30, MoCA 26) are within normal limits, and amyloid PET (AV45) is normal, making Alzheimer’s unlikely.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to conflicting imaging findings—ventricular enlargement vs. normal hippocampi and high entorhinal volume—but normal cognition and amyloid scans support CN)",
  "timestamp": "2025-07-25T20:58:24.403871"
}