{
  "ptid_time": "136_S_0186_2014-03-17",
  "img_path": "/data/qiuhui/data/adni/images/136_S_0186/2014-03-17/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 58,097 mm³, 57.2% above the reference mean. With a Z-score of 1.54 (93.9th percentile), this represents moderate enlargement; hippocampal volume measures 7,655 mm³, 17.9% above the reference mean. With a Z-score of 1.43 (92.4th percentile), this represents mild enlargement; whole brain volume measures 1,043,020 mm³, 12.4% above the reference mean. With a Z-score of 1.48 (93.1th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,848 mm³, 11.1% above the reference mean. With a Z-score of 0.60 (72.6th percentile), this represents normal volume ; fusiform gyrus volume measures 18,426 mm³, 14.4% above the reference mean. With a Z-score of 1.08 (86.0th percentile), this represents mild enlargement; middle temporal gyrus volume measures 20,003 mm³, 11.0% above the reference mean. With a Z-score of 0.97 (83.5th percentile), this represents normal volume . ",
  "text_data": "Age is 88.4 years. Gender is Female. Education: 16 years. MMSE: 25.0. MoCA: 24.0. Logical Memory: 16.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows mild to moderate enlargement in several regions, including the hippocampus and whole brain, which is atypical for Alzheimer's disease (AD) where atrophy is expected. The MMSE (25) and MoCA (24) scores are borderline but not strongly indicative of dementia, and the absence of APOE4 reduces genetic risk.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (While cognitive scores are slightly below optimal, the lack of atrophy and APOE4 suggests normal aging rather than MCI or dementia.)",
  "timestamp": "2025-07-26T15:58:24.048785"
}