{
  "ptid_time": "021_S_4421_2014-01-07",
  "img_path": "/data/qiuhui/data/adni/images/021_S_4421/2014-01-07/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 29,169 mm³, 3.9% above the reference mean. With a Z-score of 0.09 (53.6th percentile), this represents normal volume ; hippocampal volume measures 7,976 mm³, 12.1% above the reference mean. With a Z-score of 1.11 (86.7th percentile), this represents mild enlargement; whole brain volume measures 1,151,470 mm³, 18.1% above the reference mean. With a Z-score of 2.28 (98.9th percentile), this represents significant enlargement; entorhinal cortex volume measures 5,189 mm³, 41.3% above the reference mean. With a Z-score of 2.53 (99.4th percentile), this represents significant enlargement; fusiform gyrus volume measures 21,025 mm³, 23.6% above the reference mean. With a Z-score of 2.15 (98.4th percentile), this represents significant enlargement; middle temporal gyrus volume measures 19,790 mm³, 3.2% above the reference mean. With a Z-score of 0.28 (61.1th percentile), this represents normal volume . ",
  "text_data": "Age is 77.1 years. Gender is Female. Education: 14 years. MMSE: 28.0. MoCA: 24.0. Logical Memory: 15.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements show significant enlargement in multiple regions (whole brain, entorhinal cortex, fusiform gyrus) with normal hippocampal and ventricular volumes. Cognitive scores (MMSE 28, MoCA 24) are within normal to mildly impaired ranges, and APOE4-negative status reduces Alzheimer's risk.  \n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to MoCA being borderline, but structural findings suggest no neurodegeneration)",
  "timestamp": "2025-07-26T01:48:35.245380"
}