{
  "ptid_time": "127_S_5200_2017-07-07",
  "img_path": "/data/qiuhui/data/adni/images/127_S_5200/2017-07-07/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 51,651 mm³, 39.7% above the reference mean. With a Z-score of 1.07 (85.8th percentile), this represents mild enlargement; hippocampal volume measures 8,122 mm³, 25.1% above the reference mean. With a Z-score of 2.01 (97.8th percentile), this represents significant enlargement; whole brain volume measures 1,012,070 mm³, 9.0% above the reference mean. With a Z-score of 1.08 (86.1th percentile), this represents mild enlargement; entorhinal cortex volume measures 5,066 mm³, 46.3% above the reference mean. With a Z-score of 2.50 (99.4th percentile), this represents significant enlargement; fusiform gyrus volume measures 15,726 mm³, 2.4% below the reference mean. With a Z-score of -0.18 (42.9th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,323 mm³, 12.7% above the reference mean. With a Z-score of 1.13 (87.1th percentile), this represents mild enlargement. ",
  "text_data": "Age is 80.4 years. Gender is Female. Education: 18 years. MMSE: 29.0. MoCA: 30.0. Logical Memory: 14.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.91 SUVR (mild reduced). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows significant enlargement in the hippocampus and entorhinal cortex, which is atypical for Alzheimer's disease (AD), as these regions typically atrophy in AD. The MMSE and MoCA scores are normal, and there is no APOE4 risk allele. The mild reduction in AV45 (amyloid PET) suggests minimal amyloid deposition, further reducing the likelihood of AD.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to atypical volumetric findings despite normal cognition and low amyloid burden)",
  "timestamp": "2025-07-26T13:28:08.170940"
}