{
  "ptid_time": "036_S_4491_2018-03-14",
  "img_path": "/data/qiuhui/data/adni/images/036_S_4491/2018-03-14/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 51,118 mm³, 4.6% above the reference mean. With a Z-score of 0.41 (66.1th percentile), this represents normal volume ; hippocampal volume measures 6,631 mm³, 4.1% above the reference mean. With a Z-score of 0.45 (67.3th percentile), this represents normal volume ; whole brain volume measures 937,781 mm³, 6.4% below the reference mean. With a Z-score of -1.09 (13.8th percentile), this represents mild atrophy; entorhinal cortex volume measures 3,895 mm³, 1.5% below the reference mean. With a Z-score of -0.08 (47.0th percentile), this represents normal volume ; fusiform gyrus volume measures 17,113 mm³, 1.5% above the reference mean. With a Z-score of 0.18 (57.0th percentile), this represents normal volume ; middle temporal gyrus volume measures 18,364 mm³, 2.6% below the reference mean. With a Z-score of -0.40 (34.5th percentile), this represents normal volume . ",
  "text_data": "Age is 90.1 years. Gender is Male. Education: 19 years. MMSE: 28.0. MoCA: 26.0. Logical Memory: 18.0. APOEε4 alleles: 0.0. Biomarker levels: Florbetapir (AV45): 0.89 SUVR (moderate reduced). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows mild whole-brain atrophy (Z-score -1.09, 13.8th percentile), but hippocampal, entorhinal cortex, and other regional volumes are within normal ranges. Cognitive scores (MMSE 28, MoCA 26) are intact for age (90.1 years), and there is no APOE4 risk allele. Moderate AV45 (amyloid) reduction suggests some amyloid burden but not strongly indicative of Alzheimer's pathology.  \n\n**Diagnosis:** **CN (Cognitively Normal)**  \n**Confidence:** **Medium** (due to mild whole-brain atrophy and moderate amyloid reduction, but preserved cognition and normal key AD-related regions)",
  "timestamp": "2025-07-26T06:14:37.283077"
}