A medical imaging system adaptively acquires anatomical images. The system includes a synchronization processor for providing a heart rate related synchronization signal derived from a patient cardiac function blood flow related parameter. The synchronization signal enables adaptive variation in timing of acquisition within successive heart cycles of each individual image frame of multiple sequential image frames. An image acquisition device initiates acquisition of anatomical images of a portion of patient anatomy in response to the synchronization signal. A display processor presents images, acquired by the acquisition device and synchronized with the synchronization signal, to a user on a reproduction device. The image acquisition device adaptively selects image pixel resolution of individual image frames of the multiple sequential image frames in response to data identifying a heart cycle segment so that successively acquired image frames have different image pixel resolution within a single heart cycle.
