A system (29, 31) to generate a combined image from a plurality of image data, comprising: a processor system configured to execute instruction to: access a first image data acquired at a first imager position of an imager; access a final image data acquired at a final imager position of the imager; recall a first tracked position of the imager at the first imager position; recall a first subject tracked position relative to the imager at the first imager position; recall a final tracked position of the imager at the final imager position; recall a final subject tracked position relative to the imager at the final imager position; determine a transformation matrix to align the final image data to the first image data based on the recalled first subject tracked position and the recalled final subject tracked position; and output the transformation matrix, wherein the system (29, 31) further comprises: an imager configured to acquire the first image at the first imager position and the final image data at the final imager position; wherein said imager comprises a C-arm fluoroscopic imaging system or an O-arm imaging system; and a tracking system configured to track a subject and the imager, characterized in that the system (29, 31) further comprises: the processor system further configured to receive an input of a selected image dimension and execute further instructions to: determine the first imager position; determine the final imager position; and determine if at least one intermediate imager positions are required to achieve the selected image dimension; if determined that intermediate imager positions are required, determine at least one intermediate imager position. access a first image data acquired at a first imager position of an imager; access a final image data acquired at a final imager position of the imager; recall a first tracked position of the imager at the first imager position; recall a first subject tracked position relative to the imager at the first imager position; recall a final tracked position of the imager at the final imager position; recall a final subject tracked position relative to the imager at the final imager position; determine a transformation matrix to align the final image data to the first image data based on the recalled first subject tracked position and the recalled final subject tracked position; and output the transformation matrix, wherein the system (29, 31) further comprises: an imager configured to acquire the first image at the first imager position and the final image data at the final imager position; wherein said imager comprises a C-arm fluoroscopic imaging system or an O-arm imaging system; and a tracking system configured to track a subject and the imager, characterized in that the system (29, 31) further comprises: the processor system further configured to receive an input of a selected image dimension and execute further instructions to: determine the first imager position; determine the final imager position; and determine if at least one intermediate imager positions are required to achieve the selected image dimension; if determined that intermediate imager positions are required, determine at least one intermediate imager position. an imager configured to acquire the first image at the first imager position and the final image data at the final imager position; wherein said imager comprises a C-arm fluoroscopic imaging system or an O-arm imaging system; and a tracking system configured to track a subject and the imager, characterized in that the system (29, 31) further comprises: the processor system further configured to receive an input of a selected image dimension and execute further instructions to: determine the first imager position; determine the final imager position; and determine if at least one intermediate imager positions are required to achieve the selected image dimension; if determined that intermediate imager positions are required, determine at least one intermediate imager position. determine the first imager position; determine the final imager position; and determine if at least one intermediate imager positions are required to achieve the selected image dimension; if determined that intermediate imager positions are required, determine at least one intermediate imager position.