  Quantitative measures of uptake in caudate, putamen, and globus pallidus in
dopamine transporter (DaT) brain SPECT have potential as biomarkers for the
severity of Parkinson disease. Reliable quantification of uptake requires
accurate segmentation of these regions. However, segmentation is challenging in
DaT SPECT due to partial-volume effects, system noise, physiological
variability, and the small size of these regions. To address these challenges,
we propose an estimation-based approach to segmentation. This approach
estimates the posterior mean of the fractional volume occupied by caudate,
putamen, and globus pallidus within each voxel of a 3D SPECT image. The
estimate is obtained by minimizing a cost function based on the binary
cross-entropy loss between the true and estimated fractional volumes over a
population of SPECT images, where the distribution of the true fractional
volumes is obtained from magnetic resonance images from clinical populations.
The proposed method accounts for both the sources of partial-volume effects in
SPECT, namely the limited system resolution and tissue-fraction effects. The
method was implemented using an encoder-decoder network and evaluated using
realistic clinically guided SPECT simulation studies, where the ground-truth
fractional volumes were known. The method significantly outperformed all other
considered segmentation methods and yielded accurate segmentation with dice
similarity coefficients of ~ 0.80 for all regions. The method was relatively
insensitive to changes in voxel size. Further, the method was relatively robust
up to +/- 10 degrees of patient head tilt along transaxial, sagittal, and
coronal planes. Overall, the results demonstrate the efficacy of the proposed
method to yield accurate fully automated segmentation of caudate, putamen, and
globus pallidus in 3D DaT-SPECT images.
