{
  "ptid_time": "010_S_0419_2012-08-28",
  "img_path": "/data/qiuhui/data/adni/images/010_S_0419/2012-08-28/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 31,904 mm³, 17.2% below the reference mean. With a Z-score of -0.41 (34.0th percentile), this represents normal volume ; hippocampal volume measures 10,699 mm³, 41.5% above the reference mean. With a Z-score of 4.05 (100.0th percentile), this represents profound enlargement; whole brain volume measures 1,073,710 mm³, 0.5% below the reference mean. With a Z-score of -0.07 (47.3th percentile), this represents normal volume ; entorhinal cortex volume measures 4,054 mm³, 1.1% below the reference mean. With a Z-score of -0.08 (46.9th percentile), this represents normal volume ; fusiform gyrus volume measures 18,137 mm³, 3.7% below the reference mean. With a Z-score of -0.32 (37.6th percentile), this represents normal volume ; middle temporal gyrus volume measures 22,388 mm³, 4.9% above the reference mean. With a Z-score of 0.44 (67.1th percentile), this represents normal volume . ",
  "text_data": "Age is 76.2 years. Gender is Male. Education: 18 years. MMSE: 30.0. MoCA: 26.0. Logical Memory: 17.0. APOEε4 alleles: 0.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The hippocampal volume is profoundly enlarged (Z-score 4.05, 100th percentile), which is atypical for Alzheimer's disease (AD) where hippocampal atrophy is expected. Other brain volumes (ventricular, whole brain, entorhinal cortex, fusiform gyrus, middle temporal gyrus) are within normal ranges. Cognitive scores (MMSE 30, MoCA 26) are normal for age, and APOE4-negative status further reduces AD risk.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to the unusual hippocampal enlargement, which may warrant further investigation for alternative explanations)",
  "timestamp": "2025-07-25T22:30:28.763372"
}