{
  "ptid_time": "082_S_4428_2017-12-13",
  "img_path": "/data/qiuhui/data/adni/images/082_S_4428/2017-12-13/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 41,294 mm³, 7.2% above the reference mean. With a Z-score of 0.17 (56.9th percentile), this represents normal volume ; hippocampal volume measures 6,985 mm³, 7.6% below the reference mean. With a Z-score of -0.74 (23.0th percentile), this represents normal volume ; whole brain volume measures 1,110,640 mm³, 2.9% above the reference mean. With a Z-score of 0.38 (64.6th percentile), this represents normal volume ; entorhinal cortex volume measures 3,555 mm³, 13.3% below the reference mean. With a Z-score of -0.90 (18.3th percentile), this represents normal volume ; fusiform gyrus volume measures 21,221 mm³, 12.6% above the reference mean. With a Z-score of 1.08 (85.9th percentile), this represents mild enlargement; middle temporal gyrus volume measures 23,150 mm³, 8.5% above the reference mean. With a Z-score of 0.76 (77.7th percentile), this represents normal volume . ",
  "text_data": "Age is 78.6 years. Gender is Male. Education: 18 years. MMSE: 28.0. MoCA: 30.0. Logical Memory: 19.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.26 SUVR (mild elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements show mostly normal values, with mild hippocampal and entorhinal cortex atrophy (Z-scores -0.74 and -0.90, respectively), but still within the normal range. Cognitive scores (MMSE 28, MoCA 30) are intact, and there is no APOE4 risk allele. Mild AV45 (amyloid) elevation suggests early pathological changes, but no significant cognitive impairment is present.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (due to mild amyloid elevation and subtle atrophy, but preserved cognition)",
  "timestamp": "2025-07-26T10:07:45.393362"
}