A region-of-interest (ROI) fluoroscopy device that provides an automatically generated ROI filter with an arbitrary shape, as well as digitally compensated images, was built and evaluated. ROI filters were generated by using a deformable attenuation material. Images were compensated by using a compensation ratio and a running average interpolation method. Image compensation parameters were predicted on the basis of the x-ray tube potential used. The image quality with and without an ROI filter was evaluated. This ROI fluoroscopic technique was shown to substantially reduce patient and operator radiation exposure without degrading image quality within the ROI.