{
  "ptid_time": "009_S_0862_2007-04-04",
  "img_path": "/data/qiuhui/data/adni/images/009_S_0862/2007-04-04/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 22,187 mm³, 21.0% below the reference mean. With a Z-score of -0.48 (31.6th percentile), this represents normal volume ; hippocampal volume measures 6,368 mm³, 10.5% below the reference mean. With a Z-score of -0.96 (16.8th percentile), this represents normal volume ; whole brain volume measures 954,313 mm³, 2.1% below the reference mean. With a Z-score of -0.26 (39.6th percentile), this represents normal volume ; entorhinal cortex volume measures 2,769 mm³, 24.6% below the reference mean. With a Z-score of -1.51 (6.5th percentile), this represents moderate atrophy; fusiform gyrus volume measures 15,482 mm³, 9.0% below the reference mean. With a Z-score of -0.82 (20.6th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,015 mm³, 9.6% above the reference mean. With a Z-score of 0.84 (79.8th percentile), this represents normal volume . ",
  "text_data": "Age is 73.9 years. Gender is Female. Education: 12 years. MMSE: 30.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows moderate atrophy in the entorhinal cortex (Z-score -1.51, 6.5th percentile), which is an early marker of Alzheimer's pathology, while other regions (hippocampus, whole brain, fusiform gyrus, etc.) are within normal ranges. The MMSE score of 30/30 indicates no cognitive impairment, and 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 entorhinal atrophy suggesting possible preclinical Alzheimer's changes, but no clinical symptoms yet)",
  "timestamp": "2025-07-25T22:13:33.987261"
}