In one aspect, an ultrasound receive beamformer (212) is configured for one-way only beamforming (112) of transmissive ultrasound using one-way delays. The receive beamforming in some embodiments is used to track, in real time, a catheter, needle or other surgical tool within an image of a region of interest. The tool can have embedded at its tip a small ultrasound transmitter or receiver for transmitting or receiving the transmissive ultrasound. Optionally, additional transducers are fixed along the tool to provide the orientation of the tool.