Systems and methods for synthesizing a two-dimensional (2D) image of an organ of a patient by obtaining an pre-exposure x-ray image of the organ in order to ascertain parameters needed for acquisition of 2D (tomosynthesis) projection images of the organ, imaging the organ to obtain a plurality of 2D (tomosynthesis) projection images of the organ, and generating a synthetic 2D image of the organ from a combination of both the plurality of tomosynthesis projection images and the pre-exposure x-ray image.