{
  "ptid_time": "023_S_0058_2007-12-06",
  "img_path": "/data/qiuhui/data/adni/images/023_S_0058/2007-12-06/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 25,623 mm³, 33.5% below the reference mean. With a Z-score of -0.80 (21.1th percentile), this represents normal volume ; hippocampal volume measures 7,890 mm³, 4.4% above the reference mean. With a Z-score of 0.43 (66.5th percentile), this represents normal volume ; whole brain volume measures 996,816 mm³, 7.7% below the reference mean. With a Z-score of -0.99 (16.0th percentile), this represents normal volume ; entorhinal cortex volume measures 3,225 mm³, 21.4% below the reference mean. With a Z-score of -1.45 (7.4th percentile), this represents mild atrophy; fusiform gyrus volume measures 16,735 mm³, 11.2% below the reference mean. With a Z-score of -0.95 (17.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,586 mm³, 3.5% below the reference mean. With a Z-score of -0.32 (37.6th percentile), this represents normal volume . ",
  "text_data": "Age is 72.1 years. Gender is Male. Education: 16 years. MMSE: 29.0. Logical Memory: 15.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume analysis shows mild atrophy in the entorhinal cortex (Z-score -1.45, 7.4th percentile), which is an early marker of Alzheimer's pathology, but other regions (hippocampus, whole brain, fusiform gyrus, etc.) are within normal ranges. The MMSE score of 29 is intact, and there is no clinical evidence of cognitive impairment. The presence of one APOE4 allele increases Alzheimer’s risk but does not confirm pathology.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to isolated entorhinal atrophy but otherwise normal findings)",
  "timestamp": "2025-07-26T02:30:08.245776"
}