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

ROI-based reversible watermarking scheme for ensuring the integrity and authenticity of DICOM MR images

Reversible and imperceptible watermarking is recognized as a robust approach to confirm the integrity and authenticity of medical images and to verify that alterations can be detected and tracked back. In this paper, a novel blind reversible watermarking approach is presented to detect intentional and unintentional changes within brain Magnetic Resonance (MR) images. The scheme segments images into two parts; the Region of Interest (ROI) and the Region of Non Interest (RONI). Watermark data is encoded into the ROI using reversible watermarking based on the Difference Expansion (DE) technique. Experimental results show that the proposed method, whilst fully reversible, can also realize a watermarked image with low degradation for reasonable and controllable embedding capacity. This is fulfilled by concealing the data into ‘smooth’ regions inside the ROI and through the elimination of the large location map required for extracting the watermark and retrieving the original image. Our scheme delivers highly imperceptible watermarked images, at 92.18-99.94dB Peak Signal to Noise Ratio (PSNR) evaluated through implementing a clinical trial based on relative Visual Grading Analysis (relative VGA). This trial defines the level of modification that can be applied to medical images without perceptual distortion. This compares favorably to outcomes reported under current state-of-art techniques. Integrity and authenticity of medical images are also ensured through detecting subsequent changes enacted on the watermarked images. This enhanced security measure, therefore, enables the detection of image manipulations, by an imperceptible approach, that may establish increased trust in the digital medical workflow

Efficient Security and Authentication for Edge-Based Internet of Medical Things

Internet of Medical Things (IoMT)-driven smart health and emotional care is revolutionizing the healthcare industry by embracing several technologies related to multimodal physiological data collection, communication, intelligent automation, and efficient manufacturing. The authentication and secure exchange of electronic health records (EHRs), comprising of patient data collected using wearable sensors and laboratory investigations, is of paramount importance. In this article, we present a novel high payload and reversible EHR embedding framework to secure the patient information successfully and authenticate the received content. The proposed approach is based on novel left data mapping (LDM), pixel repetition method (PRM), RC4 encryption, and checksum computation. The input image of size $M imes N$ is upscaled by using PRM that guarantees reversibility with lesser computational complexity. The binary secret data are encrypted using the RC4 encryption algorithm and then the encrypted data are grouped into 3-bit chunks and converted into decimal equivalents. Before embedding, these decimal digits are encoded by LDM. To embed the shifted data, the cover image is divided into $2 imes 2$ blocks and then in each block, two digits are embedded into the counter diagonal pixels. For tamper detection and localization, a checksum digit computed from the block is embedded into one of the main diagonal pixels. A fragile logo is embedded into the cover images in addition to EHR to facilitate early tamper detection. The average peak signal to noise ratio (PSNR) of the stego-images obtained is 41.95 dB for a very high embedding capacity of 2.25 bits per pixel. Furthermore, the embedding time is less than 0.2 s. Experimental results reveal that our approach outperforms many state-of-the-art techniques in terms of payload, imperceptibility, computational complexity, and capability to detect and localize tamper. All the attributes affirm that the proposed scheme is a potential candidate for providing better security and authentication solutions for IoMT-based smart health

Digital watermarking in medical images

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University, 05/12/2005.This thesis addresses authenticity and integrity of medical images using watermarking. Hospital Information Systems (HIS), Radiology Information Systems (RIS) and Picture Archiving and Communication Systems (P ACS) now form the information infrastructure for today's healthcare as these provide new ways to store, access and distribute medical data that also involve some security risk. Watermarking can be seen as an additional tool for security measures. As the medical tradition is very strict with the quality of biomedical images, the watermarking method must be reversible or if not, region of Interest (ROI) needs to be defined and left intact. Watermarking should also serve as an integrity control and should be able to authenticate the medical image. Three watermarking techniques were proposed. First, Strict Authentication Watermarking (SAW) embeds the digital signature of the image in the ROI and the image can be reverted back to its original value bit by bit if required. Second, Strict Authentication Watermarking with JPEG Compression (SAW-JPEG) uses the same principal as SAW, but is able to survive some degree of JPEG compression. Third, Authentication Watermarking with Tamper Detection and Recovery (AW-TDR) is able to localise tampering, whilst simultaneously reconstructing the original image

AUTHENTICATION, TAMPER LOCALIZATION AND RECTIFICATION ALGORITHM WITH PRIVACY PRESERVATION OF IMAGE FOR THE CLOUD USING HMAC

Digital images like military, medical and quality control images are increasingly stored over cloud server. These images need protection against attempts to manipulate them since manipulations could tamper the decisions based on these images, many approaches have been proposed to protect the privacy of multimedia images over cloud through cryptography, these cryptographic approaches prevent the visibility of image contents but it does not identify if any changes are made on encrypted data by insider attack and cipher-text only attack. In this paper, we proposed to provide authentication, tamper localization, rectification along with privacy preservation of the image using padding extra bit plane for tamper localization, Hash message authentication code (HMAC) algorithm to authentication image, tamper rectification. The proposed algorithm will provide privacy to the image through hiding bit planes

a blockchain based proposal for protecting healthcare systems through formal methods

Abstract Blockchain technology is one of the most important and disruptive technologies in the world. Multiple industries are adopting the blockchain technology to innovate the way they work. One of the industries that are looking to adopt the blockchain is the healthcare industry. In fact, the protection of the private information stored in hospital database is a critical issue. In this paper we propose a method aimed to protect information exchanged in hospital networks, with particular regard to magnetic resonance images. As required from blockchain technology, each host network must validate the transiting data network: we exploit formal equivalence checking to perform this validation, by modeling magnetic resonance images in terms of automata by exploiting radiomic features

Secure medical image watermarking based on reversible data hiding with Arnold's cat map

The process of restoring medical images to their original form after the extraction process in application watermarking is crucial for ensuring their authenticity. Inaccurate diagnoses can occur due to distortions in medical images from conventional data embedding applications. To address this issue, reversible data hiding (RDH) method has been proposed by several researchers in recent years to embed data in medical images. After the extraction process, images can be restored to their original form with a reversible data-hiding method. In the past few years, several RDH methods have been rapidly developed, which are based on the concept of difference expansion (DE). However, it is crucial to pay attention to the security of the medical image watermarking method, the embedded data with RDH method can be easily modified, accessed, and altered by unauthorized individuals if they know the employed method. This research suggests a new approach to secure the RDH method through the use of Chaotic Map-based Arnold's Cat Map algorithms on the medical images. Data embedding was performed on random medical images using a DE method. Four gray-scale medical image modalities were used to assess the proposed method's efficacy. In our approach, we can incorporate capacity up to 0.62 bpp while maintaining a visual quality up to 41.02 dB according to PSNR and 0.9900 according to SSIM. The results indicated that it can enhance the security of the RDH method while retaining the ability to embed data and preserving the visual appearance of the medical images