{
  "ptid_time": "014_S_0520_2011-06-09",
  "img_path": "/data/qiuhui/data/adni/images/014_S_0520/2011-06-09/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 22,566 mm³, 39.0% below the reference mean. With a Z-score of -1.05 (14.7th percentile), this represents mild atrophy; hippocampal volume measures 7,806 mm³, 20.2% above the reference mean. With a Z-score of 1.62 (94.7th percentile), this represents moderate enlargement; whole brain volume measures 1,074,920 mm³, 15.8% above the reference mean. With a Z-score of 1.90 (97.1th percentile), this represents moderate enlargement; entorhinal cortex volume measures 3,177 mm³, 8.2% below the reference mean. With a Z-score of -0.45 (32.8th percentile), this represents normal volume ; fusiform gyrus volume measures 19,563 mm³, 21.4% above the reference mean. With a Z-score of 1.61 (94.6th percentile), this represents moderate enlargement; middle temporal gyrus volume measures 18,619 mm³, 3.3% above the reference mean. With a Z-score of 0.29 (61.5th percentile), this represents normal volume . ",
  "text_data": "Age is 82.7 years. Gender is Female. Education: 16 years. Handedness: Right. Race: White. Medical history: Psychiatric; Head, Eyes, Ears, Nose and Throat; Cardiovascular; Respiratory; Dermatologic-Connective Tissue; Musculoskeletal; Gastrointestinal; Allergies or Drug Sensitivities; Major Surgical Procedures. MMSE: 30.0. MoCA: 26.0. Logical Memory: 20.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows mixed findings, with mild ventricular atrophy but otherwise generally normal or even enlarged brain volumes (hippocampus, whole brain, fusiform gyrus). Cognitive scores (MMSE 30, MoCA 26) are within normal limits for age, though MoCA is borderline. APOE4 homozygous status increases Alzheimer's risk, but current imaging and cognitive performance do not indicate significant neurodegeneration.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to conflicting imaging findings and APOE4 risk, but preserved cognition)",
  "timestamp": "2025-07-25T23:42:07.181898"
}