Dopamine transporter (DAT) imaging has been used for diagnosis of Parkinson disease (PD), but a recent study has found that this approach could also be useful to determine PD prognosis. During a 5.5-year follow-up of 491 patients with PD who had dopamine deficiency, Ravina et al. found that lower baseline levels of striatal DAT, as observed on DAT imaging, were associated with increased risk of motor, cognitive and behavioural decline. Change from baseline DAT levels over 22 months was also associated with long-term PD-related outcomes.