A system for low dose x-ray imaging provides for dynamic generation of an x-ray beam with specific shape, and dynamic tracking of a detector with said beam. The detector is rotatable, and translatable along two orthogonal axes, and may mount with a circular detector tray, the tray rotating around a rotation axis. Specific detector shapes include an elongated rectangular matrix, for example with additional detector cells near the rotation center to provide an increased area of continuous detection. Dynamic low-dose x-ray tomosynthesis or limited-angle tomographic imaging is enabled via simultaneous x-ray tube and detector motions during examination, such as fluoroscopic examination of a human body. Data acquired at multiple projection angles is input to a 3D image reconstruction algorithm that provides a refreshed 3D data set during continuing examination. The system may thus also automatically track a point in three-dimensional space, for example continuously locating the tip of a catheter.