The massive number of medical images produced by fluoroscopic and other conventional diagnostic imaging devices demand a considerable amount of space for data storage. This paper proposes an effective method for lossless compression of fluoroscopic images. The main contribution in this paper is the extraction of the regions of interest (ROI) in fluoroscopic images using appropriate shapes. The extracted ROI is then effectively compressed using customized correlation and the combination of Run Length and Huffman coding, to increase compression ratio. The experimental results achieved show that the proposed method is able to improve the compression ratio by 400 % as compared to that of traditional methods.