A system and method for simultaneously imaging a structure using two different imaging modalities and blending the images into a single blended two dimensional image, is provided. The system and method include obtaining two dimensional (2D) x-ray image data (132) using an x-ray system (102) and three dimensional (3D) ultrasound image volume data (134) using an ultrasound imaging system (122). A 2D representation of the 3D ultrasound image volume data (134) is created with respect to an area of interest corresponding to the 2D x-ray image data (132). The 2D representation of the 3D ultrasound image volume data (134) is blended with the 2D x-ray image data (132) using a computer (130) to render a 2D blended image (140) of the structure that can be displayed in real-time. The computer (130) may be part of the x-ray system (102), part of the ultrasound system (122) or a standalone unit with its own display device (136).