{
  "ptid_time": "168_S_6051_2019-10-31",
  "img_path": "/data/qiuhui/data/adni/images/168_S_6051/2019-10-31/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 35,572 mm³, 59.3% above the reference mean. With a Z-score of 1.48 (93.1th percentile), this represents mild enlargement; hippocampal volume measures 7,979 mm³, 3.8% above the reference mean. With a Z-score of 0.43 (66.6th percentile), this represents normal volume ; whole brain volume measures 929,890 mm³, 9.6% below the reference mean. With a Z-score of -1.20 (11.5th percentile), this represents mild atrophy; entorhinal cortex volume measures 4,234 mm³, 8.8% above the reference mean. With a Z-score of 0.68 (75.1th percentile), this represents normal volume ; fusiform gyrus volume measures 14,733 mm³, 19.1% below the reference mean. With a Z-score of -2.15 (1.6th percentile), this represents significant atrophy; middle temporal gyrus volume measures 19,433 mm³, 5.3% below the reference mean. With a Z-score of -0.47 (31.9th percentile), this represents normal volume . ",
  "text_data": "Age is 68.3 years. Gender is Female. Education: 13 years. MMSE: 30.0. MoCA: 27.0. Logical Memory: 18.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.96 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The imaging shows mild ventricular enlargement and mild whole-brain atrophy, with significant atrophy in the fusiform gyrus, but hippocampal and entorhinal cortex volumes are normal. Cognitive scores (MMSE 30, MoCA 27) are within normal limits, and amyloid PET (AV45) is negative. APOE4-negative status further reduces Alzheimer's risk.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to fusiform gyrus atrophy, but preserved cognition and no amyloid pathology suggest non-Alzheimer’s changes, possibly age-related or vascular)",
  "timestamp": "2025-07-26T17:17:22.103900"
}