{
  "ptid_time": "013_S_1035_2007-05-30",
  "img_path": "/data/qiuhui/data/adni/images/013_S_1035/2007-05-30/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 46,416 mm³, 1.3% below the reference mean. With a Z-score of -0.04 (48.5th percentile), this represents normal volume ; hippocampal volume measures 6,615 mm³, 5.1% below the reference mean. With a Z-score of -0.44 (33.1th percentile), this represents normal volume ; whole brain volume measures 931,696 mm³, 9.5% below the reference mean. With a Z-score of -1.24 (10.7th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,706 mm³, 6.6% below the reference mean. With a Z-score of -0.43 (33.2th percentile), this represents normal volume ; fusiform gyrus volume measures 16,144 mm³, 10.6% below the reference mean. With a Z-score of -0.92 (17.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,440 mm³, 8.6% below the reference mean. With a Z-score of -0.77 (22.1th percentile), this represents normal volume . ",
  "text_data": "Age is 87.7 years. Gender is Male. Education: 20 years. MMSE: 28.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain imaging shows mild whole-brain atrophy (10.7th percentile) but otherwise normal volumes in key regions like the hippocampus, entorhinal cortex, and temporal structures. The MMSE score of 28 is within the normal range, and there are no significant cognitive deficits reported. The presence of one APOE4 allele increases Alzheimer's risk but does not confirm pathology.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to mild whole-brain atrophy in an 87-year-old, but preserved cognitive function and no focal atrophy in Alzheimer’s-vulnerable regions)",
  "timestamp": "2025-07-25T23:24:26.919499"
}