{
  "ptid_time": "010_S_0419_2006-12-15",
  "img_path": "/data/qiuhui/data/adni/images/010_S_0419/2006-12-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 26,403 mm³, 31.5% below the reference mean. With a Z-score of -0.75 (22.6th percentile), this represents normal volume ; hippocampal volume measures 11,143 mm³, 47.4% above the reference mean. With a Z-score of 4.63 (100.0th percentile), this represents profound enlargement; whole brain volume measures 1,112,090 mm³, 3.0% above the reference mean. With a Z-score of 0.39 (65.3th percentile), this represents normal volume ; entorhinal cortex volume measures 4,502 mm³, 9.8% above the reference mean. With a Z-score of 0.66 (74.7th percentile), this represents normal volume ; fusiform gyrus volume measures 19,576 mm³, 3.9% above the reference mean. With a Z-score of 0.33 (63.1th percentile), this represents normal volume ; middle temporal gyrus volume measures 23,048 mm³, 8.0% above the reference mean. With a Z-score of 0.72 (76.4th percentile), this represents normal volume . ",
  "text_data": "Age is 70.7 years. Gender is Male. Education: 18 years. MMSE: 29.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume is profoundly enlarged (Z-score 4.63, 100th percentile), which is atypical for Alzheimer's disease (AD) where hippocampal atrophy is expected. Other brain regions, including the entorhinal cortex and temporal structures, are within normal ranges. The MMSE score of 29 is normal, and the absence of APOE4 further reduces AD risk.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to the unusual hippocampal enlargement, which may warrant further investigation for other causes)",
  "timestamp": "2025-07-25T22:29:44.324650"
}