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

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

Robust watermarking for magnetic resonance images with automatic region of interest detection

Medical image watermarking requires special considerations compared to ordinary watermarking methods. The first issue is the detection of an important area of the image called the Region of Interest (ROI) prior to starting the watermarking process. Most existing ROI detection procedures use manual-based methods, while in automated methods the robustness against intentional or unintentional attacks has not been considered extensively. The second issue is the robustness of the embedded watermark against different attacks. A common drawback of existing watermarking methods is their weakness against salt and pepper noise. The research carried out in this thesis addresses these issues of having automatic ROI detection for magnetic resonance images that are robust against attacks particularly the salt and pepper noise and designing a new watermarking method that can withstand high density salt and pepper noise. In the ROI detection part, combinations of several algorithms such as morphological reconstruction, adaptive thresholding and labelling are utilized. The noise-filtering algorithm and window size correction block are then introduced for further enhancement. The performance of the proposed ROI detection is evaluated by computing the Comparative Accuracy (CA). In the watermarking part, a combination of spatial method, channel coding and noise filtering schemes are used to increase the robustness against salt and pepper noise. The quality of watermarked image is evaluated using Peak Signal-to-Noise Ratio (PSNR) and Structural Similarity Index (SSIM), and the accuracy of the extracted watermark is assessed in terms of Bit Error Rate (BER). Based on experiments, the CA under eight different attacks (speckle noise, average filter, median filter, Wiener filter, Gaussian filter, sharpening filter, motion, and salt and pepper noise) is between 97.8% and 100%. The CA under different densities of salt and pepper noise (10%-90%) is in the range of 75.13% to 98.99%. In the watermarking part, the performance of the proposed method under different densities of salt and pepper noise measured by total PSNR, ROI PSNR, total SSIM and ROI SSIM has improved in the ranges of 3.48-23.03 (dB), 3.5-23.05 (dB), 0-0.4620 and 0-0.5335 to 21.75-42.08 (dB), 20.55-40.83 (dB), 0.5775-0.8874 and 0.4104-0.9742 respectively. In addition, the BER is reduced to the range of 0.02% to 41.7%. To conclude, the proposed method has managed to significantly improve the performance of existing medical image watermarking methods