{
  "ptid_time": "006_S_0498_2011-11-15",
  "img_path": "/data/qiuhui/data/adni/images/006_S_0498/2011-11-15/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 42,239 mm³, 9.7% above the reference mean. With a Z-score of 0.23 (59.2th percentile), this represents normal volume ; hippocampal volume measures 7,214 mm³, 4.6% below the reference mean. With a Z-score of -0.45 (32.8th percentile), this represents normal volume ; whole brain volume measures 1,076,210 mm³, 0.3% below the reference mean. With a Z-score of -0.04 (48.5th percentile), this represents normal volume ; entorhinal cortex volume measures 4,893 mm³, 19.3% above the reference mean. With a Z-score of 1.31 (90.5th percentile), this represents mild enlargement; fusiform gyrus volume measures 19,777 mm³, 5.0% above the reference mean. With a Z-score of 0.42 (66.4th percentile), this represents normal volume ; middle temporal gyrus volume measures 20,704 mm³, 3.0% below the reference mean. With a Z-score of -0.27 (39.5th percentile), this represents normal volume . ",
  "text_data": "Age is 75.3 years. Gender is Male. Education: 12 years. Handedness: Right. Race: White. Medical history: Head, Eyes, Ears, Nose and Throat; Cardiovascular; Gastrointestinal; Smoking; Major Surgical Procedures. MMSE: 30.0. MoCA: 26.0. Logical Memory: 16.0. APOEε4 alleles: 1.0. ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements are largely within normal ranges, with only mild hippocampal volume reduction (-0.45 Z-score) and mild entorhinal cortex enlargement (1.31 Z-score). Cognitive scores (MMSE 30, MoCA 26) are normal for age, and there is no significant atrophy or biomarker evidence of neurodegeneration. The presence of one APOE4 allele increases Alzheimer's risk but does not confirm pathology.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to normal cognitive scores and mostly normal volumetrics, but APOE4 status and mild hippocampal reduction warrant monitoring)",
  "timestamp": "2025-07-25T21:26:58.183027"
}