{
  "ptid_time": "021_S_4335_2012-05-14",
  "img_path": "/data/qiuhui/data/adni/images/021_S_4335/2012-05-14/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 17,754 mm³, 36.7% below the reference mean. With a Z-score of -0.84 (20.0th percentile), this represents normal volume ; hippocampal volume measures 8,642 mm³, 21.5% above the reference mean. With a Z-score of 1.97 (97.6th percentile), this represents moderate enlargement; whole brain volume measures 1,091,390 mm³, 12.0% above the reference mean. With a Z-score of 1.51 (93.4th percentile), this represents moderate enlargement; entorhinal cortex volume measures 3,988 mm³, 8.6% above the reference mean. With a Z-score of 0.53 (70.1th percentile), this represents normal volume ; fusiform gyrus volume measures 20,587 mm³, 21.0% above the reference mean. With a Z-score of 1.91 (97.2th percentile), this represents moderate enlargement; middle temporal gyrus volume measures 23,487 mm³, 22.5% above the reference mean. With a Z-score of 1.96 (97.5th percentile), this represents moderate enlargement. ",
  "text_data": "Age is 72.2 years. Gender is Female. Education: 15 years. MMSE: 30.0. MoCA: 28.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows no atrophy in key regions typically affected in Alzheimer's disease (e.g., hippocampus, entorhinal cortex, middle temporal gyrus). Instead, most structures are moderately enlarged compared to reference means. Cognitive scores (MMSE 30, MoCA 28) are normal, and the absence of APOE4 further reduces Alzheimer's risk.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** High",
  "timestamp": "2025-07-26T01:44:16.984148"
}