{
  "ptid_time": "007_S_4387_2018-10-24",
  "img_path": "/data/qiuhui/data/adni/images/007_S_4387/2018-10-24/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 45,395 mm³, 22.8% above the reference mean. With a Z-score of 0.62 (73.1th percentile), this represents normal volume ; hippocampal volume measures 6,220 mm³, 4.2% below the reference mean. With a Z-score of -0.34 (36.7th percentile), this represents normal volume ; whole brain volume measures 961,382 mm³, 3.6% above the reference mean. With a Z-score of 0.43 (66.6th percentile), this represents normal volume ; entorhinal cortex volume measures 4,037 mm³, 16.6% above the reference mean. With a Z-score of 0.90 (81.5th percentile), this represents normal volume ; fusiform gyrus volume measures 17,693 mm³, 9.8% above the reference mean. With a Z-score of 0.74 (77.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,693 mm³, 9.2% above the reference mean. With a Z-score of 0.82 (79.4th percentile), this represents normal volume . ",
  "text_data": "Age is 83.1 years. Gender is Female. Education: 16 years. MMSE: 29.0. MoCA: 24.0. Logical Memory: 16.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements (hippocampus, entorhinal cortex, fusiform gyrus, middle temporal gyrus) are within normal ranges, with no significant atrophy. The MMSE score (29/30) is normal, while the MoCA (24/30) suggests mild cognitive inefficiency, which could be age-related or due to non-neurodegenerative factors (e.g., vascular, metabolic). APOE4 heterozygosity increases Alzheimer’s risk but does not confirm pathology without supporting biomarkers.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (MoCA is borderline, but structural imaging and MMSE support normal cognition; clinical context needed for subjective complaints or functional impact).",
  "timestamp": "2025-07-25T22:00:10.807954"
}