Disclosed are image recognition Artificial Intelligence (AI) training methods for multiple pulsed X-ray source-in-motion tomosynthesis imaging system. Image recognition AI training can be performed three ways: first, using existing acquired chest CT data set with known nodules to generate synthetic tomosynthesis Images, no X-ray radiation applied; second, taking X-ray raw images with anthropomorphic chest phantoms with simulated lung nodules, applying X-ray beam on phantom only; third, acquiring X-ray images using multiple pulsed source-in-motion tomosynthesis images from real patients with real known nodules and without nodules. An X-ray image recognition training network that is configured to receive X-ray training images, automatically determine whether the received images indicate a nodule or lesion condition. After training, image knowledge is updated and stored at knowledge database.