{
  "ptid_time": "082_S_1256_2007-02-16",
  "img_path": "/data/qiuhui/data/adni/images/082_S_1256/2007-02-16/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 8,826 mm³, 68.6% below the reference mean. With a Z-score of -1.57 (5.8th percentile), this represents moderate atrophy; hippocampal volume measures 7,202 mm³, 1.2% above the reference mean. With a Z-score of 0.11 (54.5th percentile), this represents normal volume ; whole brain volume measures 959,779 mm³, 1.5% below the reference mean. With a Z-score of -0.19 (42.4th percentile), this represents normal volume ; entorhinal cortex volume measures 4,653 mm³, 26.7% above the reference mean. With a Z-score of 1.64 (94.9th percentile), this represents moderate enlargement; fusiform gyrus volume measures 18,800 mm³, 10.5% above the reference mean. With a Z-score of 0.96 (83.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 19,278 mm³, 0.6% above the reference mean. With a Z-score of 0.05 (52.0th percentile), this represents normal volume . ",
  "text_data": "Age is 71.6 years. Gender is Female. Education: 17 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Dermatologic-Connective Tissue; Musculoskeletal; Endocrine-Metabolic; Gastrointestinal; Renal-Genitourinary; Allergies or Drug Sensitivities; Smoking; Major Surgical Procedures. MMSE: 30.0. Logical Memory: 12.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The patient shows moderate ventricular atrophy (Z-score -1.57) but otherwise has normal hippocampal, whole brain, and temporal lobe volumes. The entorhinal cortex is moderately enlarged, which is atypical for Alzheimer’s but not necessarily pathological. Given the normal MMSE (30/30) and lack of significant atrophy in key Alzheimer’s regions (e.g., hippocampus), cognitive impairment is unlikely.  \n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to the atypical entorhinal enlargement, though other markers suggest normal cognition)",
  "timestamp": "2025-07-26T10:01:08.526589"
}