An X-
ray diagnostic imaging
system for conducting live fluoroscopic subtraction imaging is described as including an X-
ray source for directing X-
ray radiation to a patient being examined, an x-ray imaging device positioned for receiving the X-
ray radiation and acquiring images in response thereto and a processor arranged in communication with the x-ray source and x-ray imaging device to control acquisition of a contrast-enhanced
mask image frame and a live
image frame without
contrast enhancement, to conduct a pixel shift calculation operation based on a small, user-defined
region of interest (ROI), for example, 1 / 16 of a full frame, to realize a pixel
shift vector to correct for motion between live image frames, to shift pixels comprising the
mask image frame by pixel shift directions defined by the pixel
shift vector, and to subtract the shifted
mask image frame from the live image frame to realize a live roadmapping image frame. The
system includes a display for displaying the live roadmapping image frame, and a
user interface that allows a user to define and capture the small ROI in the displayed image frame for use by the processor conducting the pixel shift calculation.