{
  "ptid_time": "022_S_2263_2019-04-16",
  "img_path": "/data/qiuhui/data/adni/images/022_S_2263/2019-04-16/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 50,468 mm³, 31.0% above the reference mean. With a Z-score of 0.74 (77.1th percentile), this represents normal volume ; hippocampal volume measures 6,835 mm³, 9.6% below the reference mean. With a Z-score of -0.94 (17.5th percentile), this represents normal volume ; whole brain volume measures 1,058,060 mm³, 2.0% below the reference mean. With a Z-score of -0.26 (39.9th percentile), this represents normal volume ; entorhinal cortex volume measures 5,351 mm³, 30.5% above the reference mean. With a Z-score of 2.07 (98.1th percentile), this represents significant enlargement; fusiform gyrus volume measures 19,187 mm³, 1.9% above the reference mean. With a Z-score of 0.16 (56.3th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,090 mm³, 1.2% below the reference mean. With a Z-score of -0.10 (45.8th percentile), this represents normal volume . ",
  "text_data": "Age is 70.0 years. Gender is Male. Education: 16 years. MMSE: 30.0. MoCA: 26.0. Logical Memory: 18.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.08 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume is slightly below the reference mean (Z-score -0.94, 17.5th percentile), but still within the normal range. The entorhinal cortex shows significant enlargement (Z-score 2.07, 98.1th percentile), which is unusual but not typical of Alzheimer's pathology. Cognitive scores (MMSE 30, MoCA 26) are within normal limits, and amyloid PET (AV45) is normal.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to the atypical entorhinal enlargement, but normal cognitive and biomarker profiles)",
  "timestamp": "2025-07-26T02:15:37.116821"
}