This invention relates to the integration of visual information, anatomic constraints, prior shape knowledge, and level set representations for the segmentation of medical images. An embodiment according to the present invention comprises a level set variational framework that uses a bi-directional boundary flow, an intensity-based regional component that maximizes the a posteriori segmentation probability, a physiology-based module that constrains the solution space and a term that accounts for shape-driven consistency. All modules are expressed in an energetic form and the resulting objective function is optimized using a gradient descent method.