An x-ray system for use with image-guided medical procedures is programmed to move in a first scan path to acquire cone beam attenuation data from which a three-dimensional digital subtraction angiogram of selected vasculature is reconstructed. The x-ray system is also programmed to move in a second scan path to acquire a series of tomosynthesis images during the inflow of a contrast agent into the selected vasculature. Parametric images are produced from information in the tomosynthesis images which indicate blood perfusion physiology of the tissues served by the vasculature.