We have implemented an effective and publicly available tool, VETOT, to track and quantify the evolution of tumors and organs over time. VETOT includes a framework both for registration and segmentation. We have evaluated the accuracy and reliability of different level set segmentation methods in order to validate this part of our software and evaluate its usability. In addition to the registration and segmentation frameworks, our program allows the creation of inter- and intra-patient atlases based on a common coordinate system defined by the landmarks selected during the registration process. Based on the National Library of Medicine's Insight toolkit, this free software is extensible and provides an intuitive interface that allows very fast processing with minimum training. This paper details VETOT and our level set segmentation evaluation.