Voxel-based reconstructions in Diffuse Optical Tomography (DOT) tend to produce very smooth images due to the attenuation of information of high spatial frequency. This then causes difficulty in estimating the spatial extent and contrast of anomalous regions such as tumors. Given an assumption that the target image is piecewise constant, we can employ a parametric model to estimate the boundaries and contrast of an inhomogeneity directly. In this paper, we describe a method to directly reconstruct such a shape boundary from diffuse optical measurements. We parameterized the object boundary using a spherical harmonic basis, and derived a new method to compute sensitivities of measurements with respect to shape parameters, based on an integral equation formulation of the forward problem. We introduced a centroid constraint to ensure uniqueness of the combined shape/center parameter estimate, and a projected Newton method was utilized to optimize the object center position and shape parameters simultaneously. Using the shape Jacobian, we also computed the Cramér-Rao lower bound on the theoretical estimator accuracy given a particular measurement configuration, object shape, and level of measurement noise. Knowledge of the shape sensitivity matrix and of the measurement noise variance allows us to visualize the shape uncertainty region in three dimensions, giving a confidence region for our shape estimate. We have implemented our shape reconstruction method, using a finite-differencebased forward model to compute the forward and adjoint fields. Reconstruction results are shown for a number of simulated target shapes, and we investigate the problem of model order selection using realistic levels of measurement noise.