{
  "ptid_time": "135_S_4863_2013-02-20",
  "img_path": "/data/qiuhui/data/adni/images/135_S_4863/2013-02-20/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 25,129 mm³, 34.8% below the reference mean. With a Z-score of -0.83 (20.3th percentile), this represents normal volume ; hippocampal volume measures 6,907 mm³, 8.6% below the reference mean. With a Z-score of -0.84 (20.0th percentile), this represents normal volume ; whole brain volume measures 1,267,320 mm³, 17.4% above the reference mean. With a Z-score of 2.26 (98.8th percentile), this represents significant enlargement; 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 20,301 mm³, 7.8% above the reference mean. With a Z-score of 0.66 (74.6th percentile), this represents normal volume ; middle temporal gyrus volume measures 21,957 mm³, 2.9% above the reference mean. With a Z-score of 0.26 (60.3th percentile), this represents normal volume . ",
  "text_data": "Age is 70.5 years. Gender is Male. Education: 18 years. MMSE: 30.0. MoCA: 26.0. Laboratory findings: Neutrophils: 77.90 (significant elevated); Lymphocytes: 14.20 (significant reduced). APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements show normal or above-normal values across most regions, including the hippocampus and entorhinal cortex, which are typically affected in Alzheimer's. The MMSE score is perfect (30/30), and the MoCA (26/30) is only mildly reduced, suggesting no significant cognitive impairment. However, the presence of two APOE4 alleles increases Alzheimer's risk, but current imaging and cognitive scores do not indicate pathology.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (due to the conflicting factors of normal imaging/cognitive scores but high genetic risk)",
  "timestamp": "2025-07-26T15:46:26.479503"
}