{
  "ptid_time": "013_S_1275_2007-09-11",
  "img_path": "/data/qiuhui/data/adni/images/013_S_1275/2007-09-11/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 57,470 mm³, 104.8% above the reference mean. With a Z-score of 2.40 (99.2th percentile), this represents significant enlargement; hippocampal volume measures 6,859 mm³, 3.6% below the reference mean. With a Z-score of -0.33 (37.1th percentile), this represents normal volume ; whole brain volume measures 941,813 mm³, 3.4% below the reference mean. With a Z-score of -0.42 (33.6th percentile), this represents normal volume ; entorhinal cortex volume measures 4,354 mm³, 18.5% above the reference mean. With a Z-score of 1.14 (87.2th percentile), this represents mild enlargement; fusiform gyrus volume measures 17,357 mm³, 2.0% above the reference mean. With a Z-score of 0.18 (57.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 17,987 mm³, 6.2% below the reference mean. With a Z-score of -0.54 (29.6th percentile), this represents normal volume . ",
  "text_data": "Age is 79.4 years. Gender is Female. Education: 20 years. MMSE: 29.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The data shows significant ventricular enlargement (Z-score 2.40), which is often associated with brain atrophy, but hippocampal volume is normal (Z-score -0.33). The MMSE score of 29 is within the normal range, suggesting intact cognitive function. The presence of two APOE4 alleles increases Alzheimer's risk, but current imaging and cognitive scores do not indicate MCI or dementia.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to conflicting markers—ventricular enlargement vs. normal cognition and hippocampal volume)",
  "timestamp": "2025-07-25T23:27:30.518752"
}