Abstract: A method for lesion segmentation in 3-dimensional (3D) digital images, includes selecting a 2D region of interest (ROI) from a 3D image, the ROI containing a suspected lesion, extending borders of the ROI to 3D forming a volume of interest (VOI), where voxels on the borders of the VOI are initialized as background voxels and voxels in an interior of the VOI are initialized as foreground voxels, propagating a foreground and background voxel competition where for each voxel in the VOI, having each neighbor voxel in a neighborhood of the voxel attack the voxel, and, if the attack is successful, updating a label and strength of the voxel with that of the successful attacking voxel, and evolving a surface between the foreground and background voxels in 3D until an energy functional associated with the surface converges in value, where the surface segments the suspected lesion from the image.