{
  "ptid_time": "082_S_6564_2018-09-17",
  "img_path": "/data/qiuhui/data/adni/images/082_S_6564/2018-09-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 41,893 mm³, 49.3% above the reference mean. With a Z-score of 1.13 (87.0th percentile), this represents mild enlargement; hippocampal volume measures 6,215 mm³, 12.6% below the reference mean. With a Z-score of -1.16 (12.3th percentile), this represents mild atrophy; whole brain volume measures 1,044,760 mm³, 7.2% above the reference mean. With a Z-score of 0.91 (81.7th percentile), this represents normal volume ; entorhinal cortex volume measures 3,868 mm³, 5.3% above the reference mean. With a Z-score of 0.33 (62.8th percentile), this represents normal volume ; fusiform gyrus volume measures 19,448 mm³, 14.3% above the reference mean. With a Z-score of 1.30 (90.4th percentile), this represents mild enlargement; middle temporal gyrus volume measures 19,481 mm³, 1.6% above the reference mean. With a Z-score of 0.14 (55.6th percentile), this represents normal volume . ",
  "text_data": "Age is 71.3 years. Gender is Female. Education: 18 years. Handedness: Right. Race: Black or African American. MMSE: 29.0. MoCA: 27.0. Logical Memory: 14.0. APOEε4 alleles: 2.0. Biomarker levels: Florbetapir (AV45): 0.94 SUVR (mild reduced). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The data shows mild hippocampal atrophy (Z-score -1.16, 12.3rd percentile) and mild ventricular enlargement (Z-score 1.13, 87th percentile), which are suggestive of early neurodegenerative changes. However, cognitive scores (MMSE 29, MoCA 27) remain within normal limits, and other brain regions (whole brain, entorhinal cortex, middle temporal gyrus) are largely preserved. The presence of two APOE4 alleles and mild amyloid burden (AV45) increases Alzheimer's risk, but current cognitive performance does not meet criteria for dementia or MCI.  \n\n**Diagnosis:** Cognitively Normal (CN)  \n**Confidence:** Medium (due to conflicting biomarkers—hippocampal atrophy suggests early pathology, but cognition is intact)",
  "timestamp": "2025-07-26T10:10:24.655139"
}