Methods of and systems for reconstructing a vascular tree shape from vascular segments imaged in a single source 2-D projection image are described. A structuring shape comprising spatial positions of reference anatomical elements is defined, such as vascular segments in the definition of a 3-D surface model corresponding to a surface defined by an anatomical structure such as a body organ (e.g., heart). The 3-D surface model is used to create a 3-D model of anatomical elements (e.g., additional vascular segments of a cardiac vasculature) imaged in a source 2-D projection image, by back-projection to the 3-D surface model. The 3-D surface model is optionally aligned by first aligning the source 2-D projection image to the structuring shape. In some embodiments, the source 2-D projection image is registered to the 3-D surface model through the structuring shape by the source image's initial use in defining the structuring shape.
