{
  "ptid_time": "041_S_0262_2008-04-09",
  "img_path": "/data/qiuhui/data/adni/images/041_S_0262/2008-04-09/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 31,050 mm³, 34.0% below the reference mean. With a Z-score of -0.99 (16.2th percentile), this represents normal volume ; hippocampal volume measures 7,557 mm³, 8.5% above the reference mean. With a Z-score of 0.73 (76.7th percentile), this represents normal volume ; whole brain volume measures 933,367 mm³, 9.3% below the reference mean. With a Z-score of -1.22 (11.1th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,351 mm³, 15.6% below the reference mean. With a Z-score of -1.02 (15.4th percentile), this represents mild atrophy; fusiform gyrus volume measures 16,682 mm³, 7.7% below the reference mean. With a Z-score of -0.66 (25.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,155 mm³, 4.9% above the reference mean. With a Z-score of 0.44 (66.9th percentile), this represents normal volume . ",
  "text_data": "Age is 87.8 years. Gender is Male. Education: 14 years. MMSE: 27.0. Logical Memory: 11.0. Laboratory findings: Total Bilirubin: 0.90 (significant elevated). APOEε4 alleles: 0.0. Biomarker levels: Pittsburgh compound B: 1.63 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain imaging shows mild atrophy in the whole brain and entorhinal cortex, but other regions (hippocampus, fusiform gyrus, middle temporal gyrus) are within normal ranges. The MMSE score of 27 is within the normal range for age, and the absence of APOE4 reduces genetic risk. Given the mild atrophy but preserved cognitive function, this suggests normal aging rather than significant neurodegeneration.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to mild atrophy in some regions but no clinical impairment)",
  "timestamp": "2025-07-26T06:56:29.771909"
}