{
  "ptid_time": "033_S_4176_2018-01-18",
  "img_path": "/data/qiuhui/data/adni/images/033_S_4176/2018-01-18/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 47,018 mm³, 3.8% below the reference mean. With a Z-score of -0.34 (36.5th percentile), this represents normal volume ; hippocampal volume measures 6,662 mm³, 4.6% above the reference mean. With a Z-score of 0.50 (69.2th percentile), this represents normal volume ; whole brain volume measures 1,051,170 mm³, 4.9% above the reference mean. With a Z-score of 0.84 (80.0th percentile), this represents normal volume ; entorhinal cortex volume measures 4,762 mm³, 20.4% above the reference mean. With a Z-score of 1.05 (85.3th percentile), this represents mild enlargement; fusiform gyrus volume measures 16,138 mm³, 4.2% below the reference mean. With a Z-score of -0.49 (31.2th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,104 mm³, 1.3% above the reference mean. With a Z-score of 0.20 (58.1th percentile), this represents normal volume . ",
  "text_data": "Age is 90.5 years. Gender is Male. Education: 20 years. MMSE: 30.0. Logical Memory: 15.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.38 SUVR (significant elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "Reasoning: The brain volume measurements (ventricular, hippocampal, whole brain, entorhinal cortex, fusiform gyrus, and middle temporal gyrus) are all within normal ranges or mildly enlarged, with no significant atrophy. The MMSE score of 30/30 indicates intact cognitive function. However, the presence of APOE4 (1 allele) and elevated AV45 (amyloid PET) suggests amyloid pathology, which is a risk factor but does not necessarily indicate current cognitive impairment.  \n\nDiagnosis: CN (Cognitively Normal)  \nConfidence: Medium (due to conflicting biomarkers—amyloid positivity vs. normal cognition and brain volumes)",
  "timestamp": "2025-07-26T05:35:52.083629"
}