High image noise in low-dose fluoroscopic x-ray often necessitates additional radiographic-dose exposures to patients to
include as part of the medical records. We present an image registration based approach for the generation of highquality
images from a sequence of low-dose x-ray fluoroscopy exposures. Image subregions in consecutively acquired
fluoroscopy frames are registered to subregions in a pre-selected reference frame using a two-dimensional
transformation model. Frames neighboring the reference image are resampled using a smooth deformation field
generated by interpolation of the individual subregion deformations. Motion-corrected neighboring frames are then
combined with the reference frame using a weighted, frequency-specific multi-resolution combination method. Using
this method, image noise (localized standard deviation) was reduced by 38% in phantom data and by 29% in clinical
barium swallow examinations. We demonstrate an effective method for generating a simulated radiographic-dose x-ray
image from a set of consecutively acquired low-dose fluoroscopy images. The significant improvement in image quality
indicates the potential of this approach to lower average patient dose by substantially reducing the need for additional
exposures for patient records.
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