{
  "ptid_time": "024_S_6385_2018-05-29",
  "img_path": "/data/qiuhui/data/adni/images/024_S_6385/2018-05-29/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 26,659 mm³, 19.3% above the reference mean. With a Z-score of 0.48 (68.6th percentile), this represents normal volume ; hippocampal volume measures 9,242 mm³, 20.3% above the reference mean. With a Z-score of 2.28 (98.9th percentile), this represents significant enlargement; whole brain volume measures 1,245,960 mm³, 21.1% above the reference mean. With a Z-score of 2.62 (99.6th percentile), this represents significant enlargement; entorhinal cortex volume measures 6,096 mm³, 56.6% above the reference mean. With a Z-score of 4.39 (100.0th percentile), this represents profound enlargement; fusiform gyrus volume measures 23,396 mm³, 28.5% above the reference mean. With a Z-score of 3.21 (99.9th percentile), this represents profound enlargement; middle temporal gyrus volume measures 18,991 mm³, 7.4% below the reference mean. With a Z-score of -0.66 (25.4th percentile), this represents normal volume . ",
  "text_data": "Age is 66.6 years. Gender is Female. Education: 16 years. Handedness: Right. Race: White. MMSE: 28.0. MoCA: 27.0. Logical Memory: 10.0. APOEε4 alleles: 0.0. Biomarker levels: Flobetaben (FBB): 0.98 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows significant to profound enlargement in multiple regions (hippocampus, whole brain, entorhinal cortex, fusiform gyrus), which is atypical for Alzheimer's disease (AD) or neurodegeneration, as these conditions typically involve atrophy. Cognitive scores (MMSE 28, MoCA 27) are within normal limits, and the absence of APOE4 further reduces AD risk. The middle temporal gyrus volume is slightly reduced but still within normal range.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** High  \n\n*(Note: The unusual volumetric enlargement may warrant further investigation for other neurological or developmental conditions, but there is no evidence of cognitive impairment or dementia based on the provided data.)*",
  "timestamp": "2025-07-26T03:25:13.370556"
}