{
  "ptid_time": "021_S_0647_2006-06-29",
  "img_path": "/data/qiuhui/data/adni/images/021_S_0647/2006-06-29/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 37,380 mm³, 3.0% below the reference mean. With a Z-score of -0.07 (47.2th percentile), this represents normal volume ; hippocampal volume measures 7,081 mm³, 6.3% below the reference mean. With a Z-score of -0.62 (26.9th percentile), this represents normal volume ; whole brain volume measures 1,011,100 mm³, 6.3% below the reference mean. With a Z-score of -0.82 (20.6th percentile), this represents normal volume ; entorhinal cortex volume measures 3,475 mm³, 15.3% below the reference mean. With a Z-score of -1.03 (15.0th percentile), this represents mild atrophy; fusiform gyrus volume measures 15,001 mm³, 20.4% below the reference mean. With a Z-score of -1.74 (4.1th percentile), this represents moderate atrophy; middle temporal gyrus volume measures 17,222 mm³, 19.3% below the reference mean. With a Z-score of -1.73 (4.1th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 72.8 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Neurologic; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Major Surgical Procedures. MMSE: 30.0. Logical Memory: 9.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain imaging shows mild to moderate atrophy in key regions associated with Alzheimer's (entorhinal cortex, fusiform gyrus, middle temporal gyrus), but hippocampal and whole-brain volumes are within normal ranges. The MMSE score of 30 is intact, and there is no APOE4 risk allele.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (Atrophy in some regions raises concern, but preserved cognition and lack of APOE4 suggest no current impairment.)",
  "timestamp": "2025-07-26T01:33:58.112331"
}