This work presents an efficient interactive segmentation system for volumetric data-sets based on advanced 3D morphological analyses and an interaction paradigm that allows a good match with user intentions. This system has been designed to produce accurate results under the complete control of the user, to minimize the interaction time and to address a generality of 3D segmentation tasks. The system has been tested and compared with other softwares on normal MR brain structure quantification and on a challenging clinical setting pointed to the detection of the presence of subtle brain atrophy associated to primitive immunodeficiency (PID). (4 pages)