{
  "ptid_time": "029_S_4585_2020-03-03",
  "img_path": "/data/qiuhui/data/adni/images/029_S_4585/2020-03-03/t1.nii.gz",
  "img_finding": "Image findings: ventricular volume measures 29,345 mm³, 23.8% below the reference mean. With a Z-score of -0.57 (28.4th percentile), this represents normal volume ; hippocampal volume measures 7,396 mm³, 2.2% below the reference mean. With a Z-score of -0.21 (41.7th percentile), this represents normal volume ; whole brain volume measures 1,013,780 mm³, 6.1% below the reference mean. With a Z-score of -0.79 (21.5th percentile), this represents normal volume ; entorhinal cortex volume measures 4,246 mm³, 3.5% above the reference mean. With a Z-score of 0.24 (59.5th percentile), this represents normal volume ; fusiform gyrus volume measures 16,561 mm³, 12.1% below the reference mean. With a Z-score of -1.03 (15.2th percentile), this represents mild atrophy; middle temporal gyrus volume measures 21,387 mm³, 0.2% above the reference mean. With a Z-score of 0.02 (50.8th percentile), this represents normal volume . ",
  "text_data": "Age is 72.8 years. Gender is Male. Education: 13 years. MMSE: 30.0. MoCA: 25.0. Logical Memory: 11.0. APOEε4 alleles: 1.0. Biomarker levels: Florbetapir (AV45): 1.06 SUVR (normal ). ",
  "true_diagnosis": "Diagnosis: CN.",
  "gpt_diagnosis": "**Reasoning:** The brain volume measurements show mostly normal values, with only mild atrophy in the fusiform gyrus. Cognitive testing (MMSE 30, MoCA 25) suggests intact global cognition with slight executive/visuospatial deficits (common in aging). APOE4 carrier status increases Alzheimer’s risk, but normal AV45 (amyloid PET) and lack of significant atrophy argue against active neurodegeneration.  \n\n**Diagnosis:** CN (Cognitively Normal)  \n**Confidence:** Medium (MoCA is borderline, but imaging and amyloid data support normal aging)",
  "timestamp": "2025-07-26T04:31:00.960067"
}