{
  "ptid_time": "094_S_4649_2012-05-10",
  "img_path": "/data/qiuhui/data/adni/images/094_S_4649/2012-05-10/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 22,305 mm³, 25.7% below the reference mean. With a Z-score of -0.61 (27.1th percentile), this represents normal volume ; hippocampal volume measures 9,700 mm³, 20.8% above the reference mean. With a Z-score of 2.08 (98.1th percentile), this represents significant enlargement; whole brain volume measures 1,264,210 mm³, 11.4% above the reference mean. With a Z-score of 1.62 (94.7th percentile), this represents moderate enlargement; entorhinal cortex volume measures 4,795 mm³, 12.5% above the reference mean. With a Z-score of 0.86 (80.6th percentile), this represents normal volume ; fusiform gyrus volume measures 22,435 mm³, 12.7% above the reference mean. With a Z-score of 1.05 (85.4th percentile), this represents mild enlargement; middle temporal gyrus volume measures 27,353 mm³, 22.0% above the reference mean. With a Z-score of 1.82 (96.5th percentile), this represents moderate enlargement. ",
  "text_data": "Age is 65.4 years. Gender is Male. Education: 18 years. Handedness: Right. Race: White. Medical history: Psychiatric; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Gastrointestinal; Renal-Genitourinary; Smoking; Major Surgical Procedures. MMSE: 30.0. MoCA: 26.0. Logical Memory: 14.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.96 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows significant enlargement in the hippocampus and moderate enlargement in the whole brain and middle temporal gyrus, which is atypical for Alzheimer's disease (AD). The MMSE score of 30 is normal, and the MoCA score of 26 is borderline but not strongly indicative of cognitive impairment. The absence of APOE4 and normal AV45 (amyloid PET) further reduce the likelihood of AD.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to the unusual enlargement in key regions, but clinical and biomarker data support normal cognition)",
  "timestamp": "2025-07-26T10:33:03.899397"
}