Computer Methods and Programs in Biomedicine XXX (2013) XXX‐XXX 1 Effective Management of Medical Information through ROI-Lossless Fragile Image Watermarking Technique

In this article, we have proposed a blind, fragile and Region of Interest (ROI) lossless medical image watermarking (MIW) technique, providing an all-in-one solution tool to various medical data distribution and management issues like security, content authentication, safe archiving, controlled access retrieval and captioning etc. The proposed scheme combines lossless data compression and encryption technique to embed electronic health record (EHR)/DICOM metadata, image hash, indexing keyword, doctor identification code and tamper localization information in the medical images. Extensive experiments (both subjective and objective) were carried out to evaluate performance of the proposed MIW technique. The findings offer suggestive evidence that the proposed MIW scheme is an effective all-in-one solution tool to various issues of medical information management domain. Moreover, given its relative simplicity, the proposed scheme can be applied to the medical images to serve in many medical applications concerned with privacy protection, safety, and management etc. Keywords

Digital watermarking : applicability for developing trust in medical imaging workflows state of the art review

Medical images can be intentionally or unintentionally manipulated both within the secure medical system environment and outside, as images are viewed, extracted and transmitted. Many organisations have invested heavily in Picture Archiving and Communication Systems (PACS), which are intended to facilitate data security. However, it is common for images, and records, to be extracted from these for a wide range of accepted practices, such as external second opinion, transmission to another care provider, patient data request, etc. Therefore, confirming trust within medical imaging workflows has become essential. Digital watermarking has been recognised as a promising approach for ensuring the authenticity and integrity of medical images. Authenticity refers to the ability to identify the information origin and prove that the data relates to the right patient. Integrity means the capacity to ensure that the information has not been altered without authorisation. This paper presents a survey of medical images watermarking and offers an evident scene for concerned researchers by analysing the robustness and limitations of various existing approaches. This includes studying the security levels of medical images within PACS system, clarifying the requirements of medical images watermarking and defining the purposes of watermarking approaches when applied to medical images

A contextual based double watermarking of PET images by patient ID and ECG signal

This paper presents a novel digital watermarking framework using electrocardiograph (ECG) and demographic text data as double watermarks. It protects patient medical information and prevents mismatching diagnostic information. The watermarks are embedded in selected texture regions of a PET image using multi-resolution wavelet decomposition. Experimental results show that modifications in these locations are visually imperceptible. The robustness of the watermarks is verified through measurement of peak signal to noise ratio (PSNR), cross-correlation (CC%), structural similarity measure (SSIM) and universal image quality index (UIQI). Their robustness is also computed using pixel-based metrics and human visual system metrics. Additionally, beta factor (β) as an edge preservation measure is used for degradation evaluation of the image boundaries throughout the watermarked PET image. Assessment of the extracted watermarks shows watermarking robustness to common attacks such as embedded zero-tree wavelet (EZW) compression and median filtering

Reversible and imperceptible watermarking approach for ensuring the integrity and authenticity of brain MR images

The digital medical workflow has many circumstances in which the image data can be manipulated both within the secured Hospital Information Systems (HIS) and outside, as images are viewed, extracted and exchanged. This potentially grows ethical and legal concerns regarding modifying images details that are crucial in medical examinations. Digital watermarking is recognised as a robust technique for enhancing trust within medical imaging by detecting alterations applied to medical images. Despite its efficiency, digital watermarking has not been widely used in medical imaging. Existing watermarking approaches often suffer from validation of their appropriateness to medical domains. Particularly, several research gaps have been identified: (i) essential requirements for the watermarking of medical images are not well defined; (ii) no standard approach can be found in the literature to evaluate the imperceptibility of watermarked images; and (iii) no study has been conducted before to test digital watermarking in a medical imaging workflow. This research aims to investigate digital watermarking to designing, analysing and applying it to medical images to confirm manipulations can be detected and tracked. In addressing these gaps, a number of original contributions have been presented. A new reversible and imperceptible watermarking approach is presented to detect manipulations of brain Magnetic Resonance (MR) images based on Difference Expansion (DE) technique. Experimental results show that the proposed method, whilst fully reversible, can also realise a watermarked image with low degradation for reasonable and controllable embedding capacity. This is fulfilled by encoding the data into smooth regions (blocks that have least differences between their pixels values) inside the Region of Interest (ROI) part of medical images and also through the elimination of the large location map (location of pixels used for encoding the data) required at extraction to retrieve the encoded data. This compares favourably to outcomes reported under current state-of-art techniques in terms of visual image quality of watermarked images. This was also evaluated through conducting a novel visual assessment based on relative Visual Grading Analysis (relative VGA) to define a perceptual threshold in which modifications become noticeable to radiographers. The proposed approach is then integrated into medical systems to verify its validity and applicability in a real application scenario of medical imaging where medical images are generated, exchanged and archived. This enhanced security measure, therefore, enables the detection of image manipulations, by an imperceptible and reversible watermarking approach, that may establish increased trust in the digital medical imaging workflow