Imaging neurological disease

1. A computer-implemented method useful in the diagnosis of a neurological disease, which comprises:

(i) obtaining a dopamine transporter radiopharmaceutical image data of a subject previously administered with a radiopharmaceutical suitable for imaging a dopamine function, wherein the obtaining includes determining the uptake of said radiopharmaceutical in an equivalent region of a left and a right striatum of a brain of said subject;

(ii) determining a value indicative of the ratio of the uptake in the equivalent left and right striatum region from the image data from step (i), wherein the ratio is calculated by dividing the uptake in the left striatum region by the uptake in the right striatum region or by dividing the uptake in the right striatum region by the uptake in the left striatum region, wherein the equivalent left and right striatum regions are regions of either the same volume (for 3-dimensional imaging) or the same area (for 2 dimensional imaging), on the left and right side of the brain; and

(iii) comparing the ratio determined in step (ii) with a range of normal subject ratios, wherein the subject is classified as suffering from a neurological disease when the ratio from step (ii) is outside of the range of normal subject ratios, and when the ratio in step (ii) is calculated by dividing the uptake in the left striatum region by the uptake in the right striatum region, the normal subject ratios are also calculated by dividing the uptake in the left striatum region by the uptake in the right striatum region, and when the ratio in step (ii) is calculated by dividing the uptake in the right striatum region by the uptake in the left striatum region, the normal subject ratios are also calculated by dividing the uptake in the right striatum region by the uptake in the left striatum region

wherein the method excludes further analysis to compare the image to age-matched and/or gender-matched control images.

2. The method of claim 1 , where the dopamine function is chosen from:

L-3,4-dihydroxyphenylalanine (DOPA) decarboxylase activity;

vesicular monoamine transporter type 2 (VMAT2) binding; or

dopamine transporter binding.

3. The method of claim 2 , where the radiopharmaceutical is a VMAT2 binding radiopharmaceutical.

4. The method of claim 3 , where the VMAT2 binding radiopharmaceutical is 18 F-AV-133.

5. The method of claim 4 , where the radiopharmaceutical is a dopamine transporter binding radiopharmaceutical.

6. The method of claim 5 , where the radiopharmaceutical comprises a tropane, and is chosen from: 123 I-ioflupane, 18 F-ioflupane, 123 I-Altropane, 123 I-PE2I, 11 C-PE2I, 123 I-IPT, 123 I-β-CIT, 18 F-β-CFT, 99 mTc-TRODAT or 99m Tc-technepine.

7. The method of claim 1 where the neurological disease is suspected to be Parkinson's disease, Parkinson's syndromes or Lewy Body Dementia.

8. The method of claim 1 , where the equivalent region is chosen from:

a whole striatum;

a caudate

a putamen; or

or combinations thereof.

9. The method of claim 1 , where the assessing of the uptake of said radiopharmaceutical in an equivalent region of the left and right striatum of the brain of said subject and/or the calculating of the ratio of the uptake in the equivalent left and right striatum region is carried out by tomographic imaging.

10. The method of claim 1 , which further comprises one or more of the following:

calculating a caudate:putamen or putamen:caudate ratio for the left and right striatum separately;

calculating a striatal binding ratio (SBR) for a left and right hemisphere;

calculating a ratio of counts in equivalent left and right regions of the brain;

comparing left:right or right:left ratios obtained in calculating the ratio of counts in equivalent left and right regions of the brain with normal values.

11. A computer-implemented method of diagnosis which comprises the method of imaging of claim 1 , where the comparing of the ratio for said subject is with a database of such ratios, wherein said database contains such ratios for normal subjects;

and further comprises:

classifying said subject as having a normal presentation, when the ratio is within the normal range; and

classifying a patient as suffering from a neurological disease when the ratio is outside the normal range.

12. A computer-implemented method of selecting or excluding a subject for a particular therapy of a neurological disease using the method of diagnosis of claim 11 , which further comprises:

assessing an uptake of said radiopharmaceutical in an equivalent region of a left and a right striatum of a brain of a subject, the subject having been previously administered a radiopharmaceutical suitable for imaging dopamine function;

calculating a ratio of the uptake in the equivalent left and right striatum region; and,

comparing the ratio for said subject with a normal range of such ratios for normal subjects.

13. A method of monitoring the efficacy of a course of therapy of a neurological disease of a subject, which comprises a method comprising:

(i) obtaining a dopamine transporter radiopharmaceutical image data of a subject previously administered with a radiopharmaceutical suitable for imaging dopamine function, wherein the obtaining includes determining the; uptake of said radiopharmaceutical in an equivalent region of a left and a right striatum of a brain of said subject;

(ii) determining a value indicative of the ratio of the uptake in the equivalent left and right striatum region from the image data from step (i), wherein the ratio is calculated by dividing the uptake in the left striatum region by the uptake in the right striatum region or by dividing the uptake in the right striatum region by the uptake in the left striatum region, wherein the equivalent left and right striatum regions are regions of either the same volume (for 3-dimensional imaging) or the same area (for 2 dimensional imaging), on the left and right side of the brain;

(iii) comparing the ratio determined in step (ii) for said subject with a normal range of such ratios for normal subjects for the subject wherein steps (i)-(iii) occur after the subject has undergone the course of therapy of the neurological disease, and when the ratio in step (ii) is calculated by dividing the uptake in the left striatum region by the uptake in the right striatum region, the normal subject ratios are also calculated by dividing the uptake in the left striatum region by the uptake in the right striatum region, and when the ratio in step (ii) is calculated by dividing the uptake in the right striatum region by the uptake in the left striatum region, the normal subject ratios are also calculated by dividing the uptake in the right striatum region by the uptake in the left striatum region; and

wherein the method excludes further analysis to compare the image to age-matched and/or gender-matched control images.

14. A personal computer, a gamma camera or a PET camera comprising a software tool suitable for carrying out the method of imaging as defined in claim 1 .

15. The personal computer, a gamma camera or a PET camera of claim 14 , further comprising the database of ratios wherein said database contains such ratios for normal subjects.

16. The method of claim 1 , wherein the method is implemented with a tomographic imaging device.