The CreateDistanceImageFromSurfaceFilter currently does not correctly support rotated MRI Images as the distanceImage that is created is aligned to the world-geometry:
origin: 0,0,0
direction: 1,1,1
After the interpolation a Surface is created from the distanceImage. This Surface is also world-aligned but has an extent that is slightly larger than one slice of the original image. Thus it's possible that a contour on a single slice will cause the segmentation to be extended to a neighboring slice as well.
When you have a rotated MR-Image, the world-aligned surface will span several slices and you will see bits of segementation that look cut-off.
The easiest way to fix this is to give the CreateDistanceImageFromSurfaceFilter the reference-image. That is the image on which the segmentation is performed. Using this information, the filter can correctly initialize the distance-image with the correct position and orientation.