{
  "ptid_time": "098_S_0896_2006-09-25",
  "img_path": "/data/qiuhui/data/adni/images/098_S_0896/2006-09-25/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 51,911 mm³, 34.8% above the reference mean. With a Z-score of 0.83 (79.8th percentile), this represents normal volume ; hippocampal volume measures 6,675 mm³, 11.7% below the reference mean. With a Z-score of -1.14 (12.7th percentile), this represents mild atrophy; whole brain volume measures 1,139,920 mm³, 5.6% above the reference mean. With a Z-score of 0.73 (76.7th percentile), this represents normal volume ; entorhinal cortex volume measures 3,509 mm³, 14.4% below the reference mean. With a Z-score of -0.98 (16.4th percentile), this represents normal volume ; fusiform gyrus volume measures 18,826 mm³, 0.1% below the reference mean. With a Z-score of -0.01 (49.8th percentile), this represents normal volume ; middle temporal gyrus volume measures 24,560 mm³, 15.1% above the reference mean. With a Z-score of 1.36 (91.3th percentile), this represents mild enlargement. ",
  "text_data": "Age is 76.8 years. Gender is Male. Education: 16 years. Handedness: Right. Race: White. Medical history: Dermatologic-Connective Tissue; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 30.0. Logical Memory: 15.0. APOEε4 alleles: 0.0. Biomarker levels: Amyloid beta: 1208.00 pg/mL (normal ); Total tau: 206.30 pg/mL (normal ); Phosphorylated tau: 17.58 pg/mL (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume shows mild atrophy (Z-score -1.14, 12.7th percentile), while other brain regions (ventricular, whole brain, entorhinal cortex, fusiform gyrus) are within normal ranges. The middle temporal gyrus shows mild enlargement, which is atypical but not necessarily pathological. Clinically, the patient has normal cognition (MMSE 30), no significant biomarkers (Aβ, T-tau, P-tau normal), and no APOE4 risk allele.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (due to hippocampal atrophy but otherwise normal clinical and biomarker profile)",
  "timestamp": "2025-07-26T10:42:09.601405"
}