A model of object shape by nets of medial and boundary primitives is justif
ied as richly capturing multiple aspects of shape and yet requiring represe
ntation space and image analysis work proportional to the number of primiti
ves. Metrics are described that compute an object representation's prior pr
obability of local geometry by reflecting variabilities in the net's node a
nd link parameter values, and that compute a likelihood function measuring
the degree of match of an image to that object representation. A paradigm f
or image analysis of deforming such a model to optimize a posteriori probab
ility is described, and this paradigm is shown to be usable as a uniform ap
proach for object definition, object-based registration between images of t
he same or different imaging modalities, and measurement of shape variation
of an abnormal anatomical object, compared with a normal anatomical object
. Examples of applications of these methods in radiotherapy, surgery, and p
sychiatry are given.