{
  "ptid_time": "020_S_6513_2020-08-20",
  "img_path": "/data/qiuhui/data/adni/images/020_S_6513/2020-08-20/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 42,262 mm³, 89.2% above the reference mean. With a Z-score of 2.23 (98.7th percentile), this represents significant enlargement; hippocampal volume measures 7,618 mm³, 0.9% below the reference mean. With a Z-score of -0.10 (46.1th percentile), this represents normal volume ; whole brain volume measures 1,119,620 mm³, 8.8% above the reference mean. With a Z-score of 1.09 (86.3th percentile), this represents mild enlargement; entorhinal cortex volume measures 3,781 mm³, 2.9% below the reference mean. With a Z-score of -0.22 (41.2th percentile), this represents normal volume ; fusiform gyrus volume measures 21,148 mm³, 16.1% above the reference mean. With a Z-score of 1.82 (96.5th percentile), this represents moderate enlargement; middle temporal gyrus volume measures 23,345 mm³, 13.8% above the reference mean. With a Z-score of 1.22 (88.9th percentile), this represents mild enlargement. ",
  "text_data": "Age is 68.1 years. Gender is Female. Education: 18 years. MMSE: 30.0. Logical Memory: 13.0. APOEε4 alleles: 1.0. Biomarker levels: Flobetaben (FBB): 1.51 SUVR (profound elevated). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The ventricular volume is significantly enlarged (Z-score 2.23), which is often associated with brain atrophy, but hippocampal and entorhinal cortex volumes are within normal limits (Z-scores -0.10 and -0.22, respectively). Whole brain, fusiform gyrus, and middle temporal gyrus volumes are mildly to moderately enlarged, which is atypical for Alzheimer's. The MMSE score of 30 is normal, and APOE4 status (heterozygous) is a risk factor but not diagnostic.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (due to conflicting findings—ventricular enlargement suggests possible atrophy, but preserved memory-related structures and normal cognition argue against MCI/dementia)",
  "timestamp": "2025-07-26T01:19:45.518256"
}