Certain embodiments of the present invention provide methods and systems for triple region image segmentation. Certain embodiments provide a method for triple region image segmentation on a picture archiving and communication system. The method includes forming an initial contour for an image including three regions using principal component analysis and a support vector machine. The method also includes segmenting the image into three regions using a single level set function based on the initial contour. Certain embodiments provide an image processing system facilitating triple region segmentation of an image. The system includes a pattern classifier including a support vector machine, the pattern classifier forming an initial contour for an image including three regions using principal component analysis and the support vector machine. The system also includes a triple region segmenter segmenting the image into three regions using a single level set function based on the initial contour.