Various implementations of the invention provide techniques and supporting systems that facilitate real-time or near-real-time ultrasound tracking for the purpose of calculating changes in anatomical features during a medical procedure. More specifically, anatomical features within a patient undergoing a medical procedure are tracked by obtaining temporally-distinct three dimensional ultrasound images that include the feature of interest and obtaining a targeted subset of ultrasound images focused on the feature. Based on the targeted subset of ultrasound images, a displacement of the feature is determined and image parameters used to obtain the targeted subset of ultrasound images are adjusted based on the displacement. This results in a time-based sequence of three dimensional images and targeted ultrasound images of the feature that identify changes in the position, size, location, and/or shape of the feature.