{
  "ptid_time": "127_S_5185_2017-08-17",
  "img_path": "/data/qiuhui/data/adni/images/127_S_5185/2017-08-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 35,141 mm³, 25.2% above the reference mean. With a Z-score of 0.58 (71.8th percentile), this represents normal volume ; hippocampal volume measures 7,123 mm³, 0.1% above the reference mean. With a Z-score of 0.01 (50.4th percentile), this represents normal volume ; whole brain volume measures 1,111,050 mm³, 14.0% above the reference mean. With a Z-score of 1.76 (96.1th percentile), this represents moderate enlargement; entorhinal cortex volume measures 4,457 mm³, 21.3% above the reference mean. With a Z-score of 1.31 (90.5th percentile), this represents mild enlargement; fusiform gyrus volume measures 16,737 mm³, 1.6% below the reference mean. With a Z-score of -0.15 (44.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,893 mm³, 3.8% above the reference mean. With a Z-score of 0.33 (62.8th percentile), this represents normal volume . ",
  "text_data": "Age is 73.9 years. Gender is Female. Education: 20 years. MMSE: 30.0. MoCA: 25.0. Logical Memory: 14.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.25 SUVR (mild elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are largely within normal ranges or even enlarged, with no significant atrophy in key regions like the hippocampus or entorhinal cortex. The MMSE score of 30 is normal, and while the MoCA score of 25 is slightly below the typical cutoff (26), it is not strongly indicative of cognitive impairment. The mild elevation in AV45 (amyloid PET) suggests some amyloid deposition, but this alone does not confirm dementia.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to mild amyloid elevation and borderline MoCA, but no structural or severe cognitive deficits)",
  "timestamp": "2025-07-26T13:27:35.972317"
}