{
  "ptid_time": "135_S_6389_2019-07-09",
  "img_path": "/data/qiuhui/data/adni/images/135_S_6389/2019-07-09/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 61,103 mm³, 58.6% above the reference mean. With a Z-score of 1.40 (92.0th percentile), this represents mild enlargement; hippocampal volume measures 7,847 mm³, 3.8% above the reference mean. With a Z-score of 0.37 (64.5th percentile), this represents normal volume ; whole brain volume measures 1,257,560 mm³, 16.5% above the reference mean. With a Z-score of 2.14 (98.4th percentile), this represents significant enlargement; entorhinal cortex volume measures 4,921 mm³, 20.0% above the reference mean. With a Z-score of 1.36 (91.3th percentile), this represents mild enlargement; fusiform gyrus volume measures 22,501 mm³, 19.4% above the reference mean. With a Z-score of 1.66 (95.1th percentile), this represents moderate enlargement; middle temporal gyrus volume measures 22,994 mm³, 7.8% above the reference mean. With a Z-score of 0.70 (75.7th percentile), this represents normal volume . ",
  "text_data": "Age is 70.7 years. Gender is Male. Education: 20 years. MMSE: 29.0. MoCA: 27.0. Logical Memory: 12.0. APOEε4 alleles: 2.0. ",
  "true_diagnosis": "Diagnosis: AD.",
  "gpt_diagnosis": "**Reasoning:** The brain volume data shows mild to moderate enlargement in several regions (ventricular, entorhinal cortex, fusiform gyrus) but normal hippocampal and middle temporal gyrus volumes. Cognitive scores (MMSE 29, MoCA 27) are within normal limits, and while APOE4 homozygosity (2 alleles) is a strong genetic risk factor for Alzheimer’s, there is no current evidence of cognitive impairment.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to conflicting findings: normal cognition but APOE4 risk and some structural changes)",
  "timestamp": "2025-07-26T15:50:52.557795"
}