{
  "ptid_time": "041_S_5097_2020-02-11",
  "img_path": "/data/qiuhui/data/adni/images/041_S_5097/2020-02-11/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 67,270 mm³, 74.6% above the reference mean. With a Z-score of 1.79 (96.3th percentile), this represents moderate enlargement; hippocampal volume measures 5,617 mm³, 25.7% below the reference mean. With a Z-score of -2.51 (0.6th percentile), this represents significant atrophy; whole brain volume measures 946,282 mm³, 12.3% below the reference mean. With a Z-score of -1.60 (5.5th percentile), this represents moderate atrophy; entorhinal cortex volume measures 3,788 mm³, 7.6% below the reference mean. With a Z-score of -0.52 (30.3th percentile), this represents normal volume ; fusiform gyrus volume measures 13,768 mm³, 26.9% below the reference mean. With a Z-score of -2.29 (1.1th percentile), this represents significant atrophy; middle temporal gyrus volume measures 16,661 mm³, 21.9% below the reference mean. With a Z-score of -1.97 (2.4th percentile), this represents moderate atrophy. ",
  "text_data": "Age is 74.5 years. Gender is Male. Education: 16 years. MMSE: 30.0. MoCA: 29.0. Logical Memory: 12.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 1.11 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging data shows significant hippocampal and fusiform gyrus atrophy, along with moderate whole brain and middle temporal gyrus atrophy, which are strongly associated with Alzheimer's pathology. However, cognitive testing (MMSE 30, MoCA 29) is normal, and amyloid PET (AV45) is negative, making neurodegenerative dementia less likely.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (due to conflicting findings—structural atrophy suggests neurodegeneration, but preserved cognition and negative amyloid argue against active disease)",
  "timestamp": "2025-07-26T07:25:50.822390"
}