{
  "ptid_time": "099_S_1034_2007-04-30",
  "img_path": "/data/qiuhui/data/adni/images/099_S_1034/2007-04-30/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 65,836 mm³, 70.9% above the reference mean. With a Z-score of 1.70 (95.5th percentile), this represents moderate enlargement; hippocampal volume measures 7,503 mm³, 0.7% below the reference mean. With a Z-score of -0.07 (47.1th percentile), this represents normal volume ; whole brain volume measures 1,127,020 mm³, 4.4% above the reference mean. With a Z-score of 0.57 (71.7th percentile), this represents normal volume ; entorhinal cortex volume measures 5,614 mm³, 36.9% above the reference mean. With a Z-score of 2.50 (99.4th percentile), this represents significant enlargement; fusiform gyrus volume measures 17,056 mm³, 9.5% below the reference mean. With a Z-score of -0.81 (21.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,972 mm³, 6.4% below the reference mean. With a Z-score of -0.58 (28.2th percentile), this represents normal volume . ",
  "text_data": "Age is 75.6 years. Gender is Male. Education: 18 years. MMSE: 28.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: MCI.",
  "gpt_diagnosis": "**Reasoning:** The ventricular volume is moderately enlarged (Z-score 1.70), which can indicate atrophy, but hippocampal volume is normal (Z-score -0.07), and whole brain volume is slightly above average (Z-score 0.57). The entorhinal cortex is significantly enlarged (Z-score 2.50), which is unusual for Alzheimer’s but may reflect individual variability. Cognitive testing (MMSE 28/30) is normal, and APOE4-negative status lowers Alzheimer’s risk.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to conflicting imaging findings despite normal cognition)",
  "timestamp": "2025-07-26T10:59:54.606807"
}