A Review of Medical Image Watermarking Requirements for Teleradiology
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paper_title: Strict integrity control of biomedical images

paper_content:

The control of the integrity and authentication of medical images is becoming ever more important within the Medical Information Systems (MIS). The intra- and interhospital exchange of images, such as in the PACS (Picture Archiving and Communication Systems), and the ease of copying, manipulation and distribution of images have brought forth the security aspects. In this paper we focus on the role of watermarking for MIS security and address the problem of integrity control of medical images. We discuss alternative schemes to extract verification signatures and compare their tamper detection performance.
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paper_title: Authentication and Data Hiding Using a Hybrid ROI-Based Watermarking Scheme for DICOM Images

paper_content:

Authenticating medical images using watermarking techniques has become a very popular area of research, and some works in this area have been reported worldwide recently. Besides authentication, many data-hiding techniques have been proposed to conceal patient’s data into medical images aiming to reduce the cost needed to store data and the time needed to transmit data when required. In this paper, we present a new hybrid watermarking scheme for DICOM images. In our scheme, two well-known techniques are combined to gain the advantages of both and fulfill the requirements of authentication and data hiding. The scheme divides the images into two parts, the region of interest (ROI) and the region of non-interest (RONI). Patient’s data are embedded into ROI using a reversible technique based on difference expansion, while tamper detection and recovery data are embedded into RONI using a robust technique based on discrete wavelet transform. The experimental results show the ability of hiding patient’s data with a very good visual quality, while ROI, the most important area for diagnosis, is retrieved exactly at the receiver side. The scheme also shows some robustness against certain levels of salt and pepper and cropping noise.
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paper_title: Medical image security in a HIPAA mandated PACS environment.

paper_content:

Medical image security is an important issue when digital images and their pertinent patient information are transmitted across public networks. Mandates for ensuring health data security have been issued by the federal government such as Health Insurance Portability and Accountability Act (HIPAA), where healthcare institutions are obliged to take appropriate measures to ensure that patient information is only provided to people who have a professional need. Guidelines, such as digital imaging and communication in medicine (DICOM) standards that deal with security issues, continue to be published by organizing bodies in healthcare. However, there are many differences in implementation especially for an integrated system like picture archiving and communication system (PACS), and the infrastructure to deploy these security standards is often lacking. Over the past 6 years, members in the Image Processing and Informatics Laboratory, Childrens Hospital, Los Angeles/University of Southern California, have actively researched image security issues related to PACS and teleradiology. The paper summarizes our previous work and presents an approach to further research on the digital envelope (DE) concept that provides image integrity and security assurance in addition to conventional network security protection. The DE, including the digital signature (DS) of the image as well as encrypted patient information from the DICOM image header, can be embedded in the background area of the image as an invisible permanent watermark. The paper outlines the systematic development, evaluation and deployment of the DE method in a PACS environment. We have also proposed a dedicated PACS security server that will act as an image authority to check and certify the image origin and integrity upon request by a user, and meanwhile act also as a secure DICOM gateway to the outside connections and a PACS operation monitor for HIPAA supporting information.
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paper_title: Digital watermarking of medical image using ROI information

paper_content:

Recently, the medical image has been digitized by the development of computer science and digitization of the medical devices. There are needs for database service of the medical image and long term storage because of the construction of PACS (Picture Archiving and Communication System) following DICOM (Digital Imaging Communications in Medicine) standards, telemedicine, and et al. Furthermore, authentication and copyright protection are required to protect the illegal distortion and reproduction of the medical information data. In this paper, we propose digital watermarking technique for medical image that prevents illegal forgery that can be caused after transmitting medical image data remotely. A wrong diagnosis may be occurred if the watermark is embedded into the whole area of image. Therefore, we embed the watermark into some area of medical image, except the decision area that makes a diagnosis so called region of interest (ROI) area in our paper, to increase invisibility. The watermark is the value of bit-plane in wavelet transform of the decision area for certification method of integrity verification. The experimental results show that the watermark embedded by the proposed algorithm can survive successfully in image processing operations such as JPEG lossy compression.
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paper_title: Lossless ROI Medical Image Watermarking Technique with Enhanced Security and High Payload Embedding

paper_content:

In this article, a new fragile, blind, high payload capacity, ROI (Region of Interest) preserving Medical image watermarking (MIW) technique in the spatial domain for gray scale medical images is proposed. We present a watermarking scheme that combines lossless data compression and encryption technique in application to medical images. The effectiveness of the proposed scheme, proven through experiments on various medical images through various image quality measure matrices such as PSNR, MSE and MSSIM enables us to argue that, the method will help to maintain Electronic Patient Report(EPR)/DICOM data privacy and medical image integrity.
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paper_title: Security Protection of DICOM Medical Images Using Dual-Layer Reversible Watermarking with Tamper Detection Capability

paper_content:

Teleradiology applications and universal availability of patient records using web-based technology are rapidly gaining importance. Consequently, digital medical image security has become an important issue when images and their pertinent patient information are transmitted across public networks, such as the Internet. Health mandates such as the Health Insurance Portability and Accountability Act require healthcare providers to adhere to security measures in order to protect sensitive patient information. This paper presents a fully reversible, dual-layer watermarking scheme with tamper detection capability for medical images. The scheme utilizes concepts of public-key cryptography and reversible data-hiding technique. The scheme was tested using medical images in DICOM format. The results show that the scheme is able to ensure image authenticity and integrity, and to locate tampered regions in the images.
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paper_title: Potential impact of HITECH security regulations on medical imaging

paper_content:

Title XIII of Division A and Title IV of Division B of the American Recovery and Reinvestment Act (ARRA) of 2009 [1] include a provision commonly referred to as the “Health Information Technology for Economic and Clinical Health Act” or “HITECH Act” that is intended to promote the electronic exchange of health information to improve the quality of health care. Subtitle D of the HITECH Act includes key amendments to strengthen the privacy and security regulations issued under the Health Insurance Portability and Accountability Act (HIPAA). The HITECH act also states that “the National Coordinator” must consult with the National Institute of Standards and Technology (NIST) in determining what standards are to be applied and enforced for compliance with HIPAA. This has led to speculation that NIST will recommend that the government impose the Federal Information Security Management Act (FISMA) [2], which was created by NIST for application within the federal government, as requirements to the public Electronic Health Records (EHR) community in the USA. In this paper we will describe potential impacts of FISMA on medical image sharing strategies such as teleradiology and outline how a strict application of FISMA or FISMA-based regulations could have significant negative impacts on information sharing between care providers.
---
paper_title: Digital Watermarking and Steganography

paper_content:

Digital audio, video, images, and documents are flying through cyberspace to their respective owners. Unfortunately, along the way, individuals may choose to intervene and take this content for themselves. Digital watermarking and steganography technology greatly reduces the instances of this by limiting or eliminating the ability of third parties to decipher the content that he has taken. The many techiniques of digital watermarking (embedding a code) and steganography (hiding information) continue to evolve as applications that necessitate them do the same. The authors of this second edition provide an update on the framework for applying these techniques that they provided researchers and professionals in the first well-received edition. Steganography and steganalysis (the art of detecting hidden information) have been added to a robust treatment of digital watermarking, as many in each field research and deal with the other. New material includes watermarking with side information, QIM, and dirty-paper codes. The revision and inclusion of new material by these influential authors has created a must-own book for anyone in this profession. ::: ::: *This new edition now contains essential information on steganalysis and steganography ::: *New concepts and new applications including QIM introduced ::: *Digital watermark embedding is given a complete update with new processes and applications
---
paper_title: Relevance of watermarking in medical imaging

paper_content:

Because of the importance of the security issues in the management of medical information, we suggest the use of watermarking techniques to complete the existing measures for protecting medical images. We discuss the necessary requirements for such a system to be accepted by medical staff and its complementary role with respect with existing security systems. We present different scenarios, one devoted to the authentication and tracing of the images, the second to the integrity control of the patient's record.
---
paper_title: Reversible medical image watermarking for tamper detection and recovery

paper_content:

This research paper discussed the usage of watermarking in medical images to ensure the authenticity and integrity of the image and reviewed some watermarking schemes that had been developed. A design of a reversible tamper detection and recovery watermarking scheme was then proposed. The watermarking scheme uses a 640x480x8 bits ultrasound grayscale image as a sample. The concept of ROI (Region Of Interest) and RONI (Region Of Non Interest) were applied. Watermark embedded can be used to detect tampering and recovery of the image can be done. The watermark is also reversible.
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paper_title: Privacy and security in teleradiology

paper_content:

Teleradiology is probably the most successful eHealth service available today. Its business model is based on the remote transmission of radiological images (e.g. X-ray and CT-images) over electronic networks, and on the interpretation of the transmitted images for diagnostic purpose. Two basic service models are commonly used teleradiology today. The most common approach is based on the message paradigm (off-line model), but more developed teleradiology systems are based on the interactive use of PACS/RIS systems. Modern teleradiology is also more and more cross-organisational or even cross-border service between service providers having different jurisdictions and security policies. This paper defines the requirements needed to make different teleradiology models trusted. Those requirements include a common security policy that covers all partners and entities, common security and privacy protection principles and requirements, controlled contracts between partners, and the use of security controls and tools that supporting the common security policy. The security and privacy protection of any teleradiology system must be planned in advance, and the necessary security and privacy enhancing tools should be selected (e.g. strong authentication, data encryption, non-repudiation services and audit-logs) based on the risk analysis and requirements set by the legislation. In any case the teleradiology system should fulfil ethical and regulatory requirements. Certification of the whole teleradiology service system including security and privacy is also proposed. In the future, teleradiology services will be an integrated part of pervasive eHealth. Security requirements for this environment including dynamic and context aware security services are also discussed in this paper.
---
paper_title: Watermarking of chest CT scan medical images for content authentication

paper_content:

Medical image is usually comprised of region of interest (ROI) and region of non interest (RONI). ROI is the region that contains the important information from diagnosis point of view so it must be stored without any distortion. We have proposed a digital watermarking technique which avoids the distortion of image in ROI by embedding the watermark information in RONI. The watermark is comprised of patient information, hospital logo and message authentication code, computed using hash function. Earlier BCH encryption of watermark is performed to ensure inaccessibility of embedded data to the adversaries.
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paper_title: Proposal for DICOM Multiframe Medical Image Integrity and Authenticity

paper_content:

This paper presents a novel algorithm to successfully achieve viable integrity and authenticity addition and verification of n-frame DICOM medical images using cryptographic mechanisms. The aim of this work is the enhancement of DICOM security measures, especially for multiframe images. Current approaches have limitations that should be properly addressed for improved security. The algorithm proposed in this work uses data encryption to provide integrity and authenticity, along with digital signature. Relevant header data and digital signature are used as inputs to cipher the image. Therefore, one can only retrieve the original data if and only if the images and the inputs are correct. The encryption process itself is a cascading scheme, where a frame is ciphered with data related to the previous frames, generating also additional data on image integrity and authenticity. Decryption is similar to encryption, featuring also the standard security verification of the image. The implementation was done in JAVA, and a performance evaluation was carried out comparing the speed of the algorithm with other existing approaches. The evaluation showed a good performance of the algorithm, which is an encouraging result to use it in a real environment.
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paper_title: A hierarchical digital watermarking method for image tamper detection and recovery

paper_content:

In this paper, we present an efficient and effective digital watermarking method for image tamper detection and recovery. Our method is efficient as it only uses simple operations such as parity check and comparison between average intensities. It is effective because the detection is based on a hierarchical structure so that the accuracy of tamper localization can be ensured. That is, if a tampered block is not detected in level-1 inspection, it will be detected in level-2 or level-3 inspection with a probability of nearly 1. Our method is also very storage effective, as it only requires a secret key and a public chaotic mixing algorithm to recover a tampered image. The experimental results demonstrate that the precision of tamper detection and localization is 99.6% and 100% after level-2 and level-3 inspection, respectively. The tamper recovery rate is better than 93% for a less than half tampered image. As compared with the method in Celik et al. [IEEE Trans. Image Process. 11(6) (2002) 585], our method is not only as simple and as effective in tamper detection and localization, it also provides with the capability of tamper recovery by trading off the quality of the watermarked images about 5dB.
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paper_title: Hybrid watermarking of medical images for ROI authentication and recovery

paper_content:

Medical image data require strict security, confidentiality and integrity. To achieve these stringent requirements, we propose a hybrid watermarking method which embeds a robust watermark in the region of non-interest (RONI) for achieving security and confidentiality, while integrity control is achieved by inserting a fragile watermark into the region of the interest (ROI). First the information to be modified in ROI is separated and is inserted into RONI, which later is used in recovery of the original ROI. Secondly, to avoid the underflow and overflow, a location map is generated for embedding the watermark block-wise by leaving the suspected blocks. This avoids the preprocessing step of histogram modification. The image visual quality, as well as tamper localization, is evaluated. We use weighted peak signal to noise ratio for measuring image quality of watermarked images. Experimental results show that the proposed method outperforms the existing hybrid watermarking techniques.
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paper_title: Four-scanning attack on hierarchical digital watermarking method for image tamper detection and recovery

paper_content:

In a recent paper presented by Lin et al., a block-based hierarchical watermarking algorithm for digital images is proposed. It adopts parity check and the intensity-relation check to conduct the experiment of image tamper detection. Their experimental results indicate that the precision of tamper detection and localization is 99.6% and 100% after level-2 and level-3 inspections, respectively. The proposed attacks demonstrate that this watermarking algorithm is fundamentally flawed in that the attacker can tamper a watermarked image easily without being detected. In this paper, a four-scanning attack aimed to Lin et al.'s watermarking method is presented to create tampered images. Furthermore, in case they use encryption to protect their 3-tuple-watermark, we proposed a blind attack to tamper watermarked images without being detected. Experimental results are given to support and enhance our conclusions, and demonstrate that our attacks are successful in tampering watermarked images.
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paper_title: Digital watermarking of medical image using ROI information

paper_content:

Recently, the medical image has been digitized by the development of computer science and digitization of the medical devices. There are needs for database service of the medical image and long term storage because of the construction of PACS (Picture Archiving and Communication System) following DICOM (Digital Imaging Communications in Medicine) standards, telemedicine, and et al. Furthermore, authentication and copyright protection are required to protect the illegal distortion and reproduction of the medical information data. In this paper, we propose digital watermarking technique for medical image that prevents illegal forgery that can be caused after transmitting medical image data remotely. A wrong diagnosis may be occurred if the watermark is embedded into the whole area of image. Therefore, we embed the watermark into some area of medical image, except the decision area that makes a diagnosis so called region of interest (ROI) area in our paper, to increase invisibility. The watermark is the value of bit-plane in wavelet transform of the decision area for certification method of integrity verification. The experimental results show that the watermark embedded by the proposed algorithm can survive successfully in image processing operations such as JPEG lossy compression.
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paper_title: Security for the digital information age of medicine: Issues, applications, and implementation

paper_content:

Privacy and integrity of medical records is expected by patients. This privacy and integrity is often mandated by regulations. Traditionally, the security of medical records has been based on physical lock and key. As the storage of patient record information shifts from paper to digital, new security concerns arise. Digital cryptographic methods provide solutions to many of these new concerns. In this article we give an overview of new security concerns, new legislation mandating secure medical records and solutions providing security.
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paper_title: Potential impact of HITECH security regulations on medical imaging

paper_content:

Title XIII of Division A and Title IV of Division B of the American Recovery and Reinvestment Act (ARRA) of 2009 [1] include a provision commonly referred to as the “Health Information Technology for Economic and Clinical Health Act” or “HITECH Act” that is intended to promote the electronic exchange of health information to improve the quality of health care. Subtitle D of the HITECH Act includes key amendments to strengthen the privacy and security regulations issued under the Health Insurance Portability and Accountability Act (HIPAA). The HITECH act also states that “the National Coordinator” must consult with the National Institute of Standards and Technology (NIST) in determining what standards are to be applied and enforced for compliance with HIPAA. This has led to speculation that NIST will recommend that the government impose the Federal Information Security Management Act (FISMA) [2], which was created by NIST for application within the federal government, as requirements to the public Electronic Health Records (EHR) community in the USA. In this paper we will describe potential impacts of FISMA on medical image sharing strategies such as teleradiology and outline how a strict application of FISMA or FISMA-based regulations could have significant negative impacts on information sharing between care providers.
---
paper_title: Relevance of watermarking in medical imaging

paper_content:

Because of the importance of the security issues in the management of medical information, we suggest the use of watermarking techniques to complete the existing measures for protecting medical images. We discuss the necessary requirements for such a system to be accepted by medical staff and its complementary role with respect with existing security systems. We present different scenarios, one devoted to the authentication and tracing of the images, the second to the integrity control of the patient's record.
---
paper_title: Privacy and security in teleradiology

paper_content:

Teleradiology is probably the most successful eHealth service available today. Its business model is based on the remote transmission of radiological images (e.g. X-ray and CT-images) over electronic networks, and on the interpretation of the transmitted images for diagnostic purpose. Two basic service models are commonly used teleradiology today. The most common approach is based on the message paradigm (off-line model), but more developed teleradiology systems are based on the interactive use of PACS/RIS systems. Modern teleradiology is also more and more cross-organisational or even cross-border service between service providers having different jurisdictions and security policies. This paper defines the requirements needed to make different teleradiology models trusted. Those requirements include a common security policy that covers all partners and entities, common security and privacy protection principles and requirements, controlled contracts between partners, and the use of security controls and tools that supporting the common security policy. The security and privacy protection of any teleradiology system must be planned in advance, and the necessary security and privacy enhancing tools should be selected (e.g. strong authentication, data encryption, non-repudiation services and audit-logs) based on the risk analysis and requirements set by the legislation. In any case the teleradiology system should fulfil ethical and regulatory requirements. Certification of the whole teleradiology service system including security and privacy is also proposed. In the future, teleradiology services will be an integrated part of pervasive eHealth. Security requirements for this environment including dynamic and context aware security services are also discussed in this paper.
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paper_title: How to deal with security issues in teleradiology

paper_content:

Abstract The use of teleradiological systems for medical image communication is increasing significantly. Digital images can be transferred over public telephone (e.g. ISDN) lines to colleagues for interpretation and/or consultation. Thus, a new quality is being introduced into the process of radiological diagnostics. However, technical implementation of such systems is accompanied by little consideration of legal, i.e. data protection and security, issues. In this paper we describe a concept for data protection in teleradiology which unites aspects of privacy and security as well as user aspects. After highlighting the legal situation in Germany we describe the methodology used for deriving the security profile for teleradiology in Germany. As a result the set of security measures which have to be employed with a teleradiology system is listed. A detailed description follows of how the software requirements are implemented in the teleradiology software MEDICUS.
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paper_title: Strict integrity control of biomedical images

paper_content:

The control of the integrity and authentication of medical images is becoming ever more important within the Medical Information Systems (MIS). The intra- and interhospital exchange of images, such as in the PACS (Picture Archiving and Communication Systems), and the ease of copying, manipulation and distribution of images have brought forth the security aspects. In this paper we focus on the role of watermarking for MIS security and address the problem of integrity control of medical images. We discuss alternative schemes to extract verification signatures and compare their tamper detection performance.
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paper_title: Secure method for sectional image archiving and transmission

paper_content:

Purpose: Data security becomes an important issue in telemedicine when medical information is transmitted over wide area network. Generally, security is characterized in terms of privacy, authenticity and integrity of digital data. We present a method here which can meet the requirements of privacy, authenticity, and integrity for archiving and transmitting of sectional image such as CT, MR. Methods: The method is described as follows: firstly, image segmentation was done and some patient information was read from image DICOM header. Second, a digital signature for the segmented image was produced using the image sender's private key. Afterwards, the digital signature and patient information were concatenated and embedded into the background area of the image. Finally, the whole image was encrypted to form a digital envelope using the receiver's public key. Results: (1) The image can only be decrypted and read by authorized user who own the private key of the receiving site. (2) The authenticity and integrity can be tested by signature verification. Conclusions: The preliminary results demonstrate that the method we presented here is an effective method for secure archiving and transmitting for sectional medical images.
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paper_title: Fundamentals of Network Security

paper_content:

Basic Security Concepts - Why is Computer and Network Security Important. Background and History. The Security Trinity. Information Security. Risk Assessment. Security Models. Basic Terminology. More Basic Terminology. Threats, Vulnerabilities and Attacks - Protocols. The OSI Reference Model. TCP/IP Protocol Suite. Useful Web Sites. Search Engines. Mailing Lists. Encryption, Digital Signatures and Certification - Cryptography. Stream Ciphers. Breaking Ciphers. Block Ciphers. Encryption. Public Key Cryptosystems. Message Integrity. Authentication. Digital Signatures. Competing Standards. Digital Certificates. Limitations of Digital Certificates. Certificate Authorities. Public Key Infrastructure. The Future. The Limitations of Encryption. Kerberos - How Kerberos Works. Kerberos- Limitations. Encryption on the WWW - The World Wide Web. Secure Sockets Layer (HTTPS). Secure HTTP (SHTTP). Microsoft's Internet Explorer. Viewing Digital Certificates with Internet Explorer. Viewing the Encryption Strength of IE5. Viewing Certification Authorities with IE5. Netscape Navigator. Viewing Digital Certificates with Navigator. Authenticode Certificates. E-Mail - E-Mail Issues. E-Mail Issues. Secure E-Mail Protocols. Web-Based E-Mail Services. Security of Stored Messages. Identity: Spoofing and Hiding. E-Mail as a weapon. E-Mail Policies. E-Mail Privacy. Auto-Responses. Operating System Security -- Passwords. Password Attacks. Onetime Passwords. Access Control. Data Redundancy. General Recommendations. Modems. Useful Tools. LAN Security - LAN Guidelines. Controlling End-User Access. Concurrent Logins. Available Disk Space. Restrictions to Location or Workstation. Time/Day Restrictions. Access to Directories and Trustee Rights. File Attributes. Other Privileges. Single Sign-On. Policy-Based Network Management. Honeypot Systems. Network Segmentation. Static IP Addresses vs. DHCP. Media and Protocols - Network Media. Plenum Cabling and Risers. WANs. Redundancy and Alternative Connections. Routers and SNMP - Router Issues. SNMP. Virtual Private Networks - Encryption on the Network. Node-to-Node Encryption. End-to-End Encryption. Where to Encrypt. Virtual Private Networks. PPTP. L2TP. IPSec. SOCKS. Firewalls - Firewalls Pros and Cons. Types of Firewalls. Packet Filters vs. Proxies. Firewall Configurations. Restricting Users' Access to the Internet. Firewall Products. Personal Firewalls. Biometrics - Identification and Authentication. Biometric Identification and Authentication. Biometric Identification Reliability. Backup Authentication. Environmental Conditions. User Acceptance. Security of the Biometric System. Interoperability. Costs vs. Savings. Policies and Procedures - Policies vs. Procedures. Information Security Policy Objectives. Developing Security Policies. Policy and Procedure Manuals. Policy Awareness & Education. Policy Enforcement. Policy Format. Security Policy Suggestions. Information Protection Team. Crisis Management Planning. Sources for Information Policies. Auditing and Intrusion Detection - What is an Audit. Operational Security Audits. System Security Auditing. Activity and Usage Auditing. Audit Mistakes. Deficiencies of Traditional Audit Techniques. Intrusion Detection. Intrusion Detection Systems. Host-Based Intrusion Detection Systems. Network-Based Intrusion Detection Systems. Knowledge-Based Intrusion Detection Systems. Statistical-Based Intrusion Detection Systems. Defense In-Depth Approach . Future Directions. Crisis Management Planning - Crisis Management. Disaster Recovery Planning. Computer Security Incident Response Plan. Browser Security - Cookie Files. Cache Files. Autocomplete.
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paper_title: Medical image security in a HIPAA mandated PACS environment.

paper_content:

Medical image security is an important issue when digital images and their pertinent patient information are transmitted across public networks. Mandates for ensuring health data security have been issued by the federal government such as Health Insurance Portability and Accountability Act (HIPAA), where healthcare institutions are obliged to take appropriate measures to ensure that patient information is only provided to people who have a professional need. Guidelines, such as digital imaging and communication in medicine (DICOM) standards that deal with security issues, continue to be published by organizing bodies in healthcare. However, there are many differences in implementation especially for an integrated system like picture archiving and communication system (PACS), and the infrastructure to deploy these security standards is often lacking. Over the past 6 years, members in the Image Processing and Informatics Laboratory, Childrens Hospital, Los Angeles/University of Southern California, have actively researched image security issues related to PACS and teleradiology. The paper summarizes our previous work and presents an approach to further research on the digital envelope (DE) concept that provides image integrity and security assurance in addition to conventional network security protection. The DE, including the digital signature (DS) of the image as well as encrypted patient information from the DICOM image header, can be embedded in the background area of the image as an invisible permanent watermark. The paper outlines the systematic development, evaluation and deployment of the DE method in a PACS environment. We have also proposed a dedicated PACS security server that will act as an image authority to check and certify the image origin and integrity upon request by a user, and meanwhile act also as a secure DICOM gateway to the outside connections and a PACS operation monitor for HIPAA supporting information.
---
paper_title: Medical Image Authentication Using DPT Watermarking: A Preliminary Attempt

paper_content:

Secure authentication of digital medical image content provides great value to the e-Health community and medical insurance industries. Fragile Watermarking has been proposed to provide the mechanism to authenticate digital medical image securely. Transform Domain based Watermarking are typically slower than spatial domain watermarking owing to the overhead in calculation of coefficients. In this paper, we propose a new Discrete Pascal Transform based watermarking technique. Preliminary experiment result shows authentication capability. Possible improvements on the proposed scheme are also presented before conclusions.
---
paper_title: Digital Watermarking and Steganography

paper_content:

Digital audio, video, images, and documents are flying through cyberspace to their respective owners. Unfortunately, along the way, individuals may choose to intervene and take this content for themselves. Digital watermarking and steganography technology greatly reduces the instances of this by limiting or eliminating the ability of third parties to decipher the content that he has taken. The many techiniques of digital watermarking (embedding a code) and steganography (hiding information) continue to evolve as applications that necessitate them do the same. The authors of this second edition provide an update on the framework for applying these techniques that they provided researchers and professionals in the first well-received edition. Steganography and steganalysis (the art of detecting hidden information) have been added to a robust treatment of digital watermarking, as many in each field research and deal with the other. New material includes watermarking with side information, QIM, and dirty-paper codes. The revision and inclusion of new material by these influential authors has created a must-own book for anyone in this profession. ::: ::: *This new edition now contains essential information on steganalysis and steganography ::: *New concepts and new applications including QIM introduced ::: *Digital watermark embedding is given a complete update with new processes and applications
---
paper_title: Relevance of watermarking in medical imaging

paper_content:

Because of the importance of the security issues in the management of medical information, we suggest the use of watermarking techniques to complete the existing measures for protecting medical images. We discuss the necessary requirements for such a system to be accepted by medical staff and its complementary role with respect with existing security systems. We present different scenarios, one devoted to the authentication and tracing of the images, the second to the integrity control of the patient's record.
---
paper_title: Watermarking of chest CT scan medical images for content authentication

paper_content:

Medical image is usually comprised of region of interest (ROI) and region of non interest (RONI). ROI is the region that contains the important information from diagnosis point of view so it must be stored without any distortion. We have proposed a digital watermarking technique which avoids the distortion of image in ROI by embedding the watermark information in RONI. The watermark is comprised of patient information, hospital logo and message authentication code, computed using hash function. Earlier BCH encryption of watermark is performed to ensure inaccessibility of embedded data to the adversaries.
---
paper_title: Conception and limits of robust perceptual hashing: towards side information assisted hash functions

paper_content:

In this paper, we consider some basic concepts behind the design of existing robust perceptual hashing techniques for content identification. We show the limits of robust hashing from the communication perspectives as well as propose an approach that is able to overcome these shortcomings in certain setups. The consideration is based on both achievable rate and probability of error. We use the fact that most robust hashing algorithms are based on dimensionality reduction using random projections and quantization. Therefore, we demonstrate the corresponding achievable rate and probability of error based on random projections and compare with the results for the direct domain. The effect of dimensionality reduction is studied and the corresponding approximations are provided based on the Johnson-Lindenstrauss lemma. Side-information assisted robust perceptual hashing is proposed as a solution to the above shortcomings.
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paper_title: Experiment of Tamper Detection and Recovery Watermarking in PACS

paper_content:

Medical images such as x-rays, ultrasounds and MRI (Magnetic Resonance Imaging) plays an important role in helping the physicians to diagnose a disease or body conditions. These images can be tampered with existing image processing tools that is easily available. The usage of security measures such as watermarking can protect the integrity of the images. Numerous watermarking schemes with basic security functions and even tampered image recovery are available. But there is no research on the experimentation of watermarking in the operational environment that involves PACS (Picture Archiving and Communication Systems). This paper will focus on the experiment of selected watermarking scheme running in as imulated operation environment. The watermarked images will be tested to know its effectiveness by comparing its recovery rates.
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paper_title: JPEG 2000 and Digital Watermarking Technique Using in Medical Image

paper_content:

The Picture Archiving and Communication System(PACS) was introduced for computerization of the medical system and telediagnosis between the hospital. It is becoming possible to create, store, and transmit medical images via PACS. There has been a growing interest in protecting medical images with an enormous amount of information. To improve transmission speed among the hospitals, the medical image should be compression JPEG 2000 by high compression ratio. This paper proposes an algorithm that utilizes both JPEG 2000 and robust watermarking for protection and compression of the medical image. With the proposed algorithm, it takes considerably less time to do JPEG 2000 and watermarking than when they are done separately. Based on the experiment results, it takes 0.72 second for the proposed algorithm and 1.11 second when they are done separately. We confirmed that the proposed algorithm was faster than when they are done separately.
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paper_title: Reversible medical image watermarking for tamper detection and recovery

paper_content:

This research paper discussed the usage of watermarking in medical images to ensure the authenticity and integrity of the image and reviewed some watermarking schemes that had been developed. A design of a reversible tamper detection and recovery watermarking scheme was then proposed. The watermarking scheme uses a 640x480x8 bits ultrasound grayscale image as a sample. The concept of ROI (Region Of Interest) and RONI (Region Of Non Interest) were applied. Watermark embedded can be used to detect tampering and recovery of the image can be done. The watermark is also reversible.
---
paper_title: Security models of digital watermarking

paper_content:

Digital watermarking, traditionally modeled as communication with side information, is generally considered to have important potential applications in various scenarios such as digital rights managements. However, the current literature mainly focuses on robustness, capacity and imperceptibility. There lacks systematic formal approach in tackling secure issues of watermarking. One one hand, the threat models in many previous works are not sufficiently established, which result in somewhat superficial or even flawed security analysis. On the other hand, there lacks a rigorous model for watermarking in general that allows useful analysis in practice. There has been some efforts in clearing the threat models and formulate rigorous watermarking models. However, there are also many other cases where security issues are lightly or incorrectly treated. In this paper, we survey various security notions and models in previous work, and discuss possible future research directions.
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paper_title: Non-repudiation oblivious watermarking schema for secure digital video distribution

paper_content:

This paper presents a mechanism and algorithm for creating undeniable watermarks. It assumes a system where a content owner or provider uses outside agents to distribute its content. Content watermarked by distribution agents using this system will be undeniably recognizable by the content provider as originating with that distribution agent. That is to say that given N distribution agents, the content provider will be able to tell which distribution agent watermarked the content. The system does not allow any distribution agent to watermark content that would appear to have been watermarked by another agent and it does also not allow the content provider to watermark content that would appear to have been watermarked by a particular distribution agent. This allows the content provider to place a high degree of trust in the identification of the distribution agent and trace "leak" locations of pirated copies of videos.
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paper_title: Tamper Detection and Recovery for Medical Images Using Near-lossless Information Hiding Technique

paper_content:

Digital medical images are very easy to be modified for illegal purposes. For example, microcalcification in mammography is an important diagnostic clue, and it can be wiped off intentionally for insurance purposes or added intentionally into a normal mammography. In this paper, we proposed two methods to tamper detection and recovery for a medical image. A 1024 × 1024 x-ray mammogram was chosen to test the ability of tamper detection and recovery. At first, a medical image is divided into several blocks. For each block, an adaptive robust digital watermarking method combined with the modulo operation is used to hide both the authentication message and the recovery information. In the first method, each block is embedded with the authentication message and the recovery information of other blocks. Because the recovered block is too small and excessively compressed, the concept of region of interest (ROI) is introduced into the second method. If there are no tampered blocks, the original image can be obtained with only the stego image. When the ROI, such as microcalcification in mammography, is tampered with, an approximate image will be obtained from other blocks. From the experimental results, the proposed near-lossless method is proven to effectively detect a tampered medical image and recover the original ROI image. In this study, an adaptive robust digital watermarking method combined with the operation of modulo 256 was chosen to achieve information hiding and image authentication. With the proposal method, any random changes on the stego image will be detected in high probability.
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paper_title: The integration of medical images with the electronic patient record and their web-based distribution

paper_content:

Abstract Medical images are currently created digitally and stored in the radiology department’s picture archiving and communication system. Reports are usually stored in the electronic patient record of other information systems, such as the radiology information system (RIS) and the hospital information system (HIS). But high-quality services can only be provided if electronic patient record data is integrated with digital images in picture archiving and communication systems. Clinicians should be able to access both systems’ data in an integrated and consistent way as part of their regular working environment, whether HIS or RIS. Also, this system should allow for teleconferencing with other users, eg, for consultation with a specialist in the radiology department. This article describes a web-based solution that integrates the digital images of picture archiving and communication systems with electronic patient record/HIS/RIS data and has built-in teleconferencing functionality. This integration has been successfully tested using three different commercial RIS and HIS products.
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paper_title: Applications of data hiding in digital images

paper_content:

Summary form only given, as follows. The author introduces data hiding in digital imagery as a new and powerful technology with applications including robust digital watermarking of images for copyright protection, image fingerprinting and authentication, tamper detection in digital imagery, covert (invisible) communication using images, access control, copy control in DVDs, embedding subtitles and audio tracks in video signals, etc. Data hiding is a highly multidisciplinary field that combines image and signal processing with cryptography, communication theory, coding theory, signal compression, and the theory of visual perception.
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paper_title: A data-hiding technique with authentication, integration, and confidentiality for electronic patient records

paper_content:

A data-hiding technique called the "bipolar multiple-number base" was developed to provide capabilities of authentication, integration, and confidentiality for an electronic patient record (EPR) transmitted among hospitals through the Internet. The proposed technique is capable of hiding those EPR related data such as diagnostic reports, electrocardiogram, and digital signatures from doctors or a hospital into a mark image. The mark image could be the mark of a hospital used to identify the origin of an EPR. Those digital signatures from doctors and a hospital could be applied for the EPR authentication. Thus, different types of medical data can be integrated into the same mark image. The confidentiality is ultimately achieved by decrypting the EPR related data and digital signatures with an exact copy of the original mark image. The experimental results validate the integrity and the invisibility of the hidden EPR related data. This newly developed technique allows all of the hidden data to be separated and restored perfectly by authorized users.
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paper_title: Survey of Medical Image Watermarking Algorithms

paper_content:

Watermarking in medical images is a new area of research and some works in this area have been reported world wide recently. Most of the works are on the tamper detection of the images and embedding of the Electronics Patient Record (EPR) data in the medical images. Watermarked medical images can be used for transmission, storage or telediagnosis. Tamper detection watermarks are useful to locate the regions in the image where some manipulations have been made. EPR data hiding in images improves the confidentiality of the patient data, saves memory storage space and reduce the bandwidth requirement for transmission of images. This paper discusses various aspects of medical image watermarking and makes a review of various watermarking algorithms originally proposed for medical images.
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paper_title: Lossless ROI Medical Image Watermarking Technique with Enhanced Security and High Payload Embedding

paper_content:

In this article, a new fragile, blind, high payload capacity, ROI (Region of Interest) preserving Medical image watermarking (MIW) technique in the spatial domain for gray scale medical images is proposed. We present a watermarking scheme that combines lossless data compression and encryption technique in application to medical images. The effectiveness of the proposed scheme, proven through experiments on various medical images through various image quality measure matrices such as PSNR, MSE and MSSIM enables us to argue that, the method will help to maintain Electronic Patient Report(EPR)/DICOM data privacy and medical image integrity.
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paper_title: Relevance of watermarking in medical imaging

paper_content:

Because of the importance of the security issues in the management of medical information, we suggest the use of watermarking techniques to complete the existing measures for protecting medical images. We discuss the necessary requirements for such a system to be accepted by medical staff and its complementary role with respect with existing security systems. We present different scenarios, one devoted to the authentication and tracing of the images, the second to the integrity control of the patient's record.
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paper_title: The Use of Digital Watermarking for Intelligence Multimedia Document Distribution

paper_content:

Digital watermarking is a promising technology to embed information as unperceivable signals in digital contents. Various watermarking techniques have been proposed to protect copyrights of multimedia digital contents over Internet trading so that ownership of the contents can be determined in subsequent copyrights disputes. However, their applications in preventing unauthorized distribution of intelligence document have not been studied. In this paper, we propose a watermark-based document distribution protocol, which complements conventional cryptography-based access control schemes, to address the problem of tracing unauthorized distribution of sensitive intelligence documents. The reinforcement of document distribution policies requires a concrete support of non-repudiation in the distribution process. The distribution protocol is adapted from our previous work on the watermarking infrastructure for enterprise document management. It makes use of intelligence user certificates to embed the identity of the users into the intelligence documents to whom are distributed. In particular, keeping the identity secrecy between document providers and users (but yet traceable upon disputes) is a key contribution of this protocol in order to support for intelligence applications. We also outline an implementation of the distribution protocol and watermarking scheme employed.
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paper_title: Watermarking of chest CT scan medical images for content authentication

paper_content:

Medical image is usually comprised of region of interest (ROI) and region of non interest (RONI). ROI is the region that contains the important information from diagnosis point of view so it must be stored without any distortion. We have proposed a digital watermarking technique which avoids the distortion of image in ROI by embedding the watermark information in RONI. The watermark is comprised of patient information, hospital logo and message authentication code, computed using hash function. Earlier BCH encryption of watermark is performed to ensure inaccessibility of embedded data to the adversaries.
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paper_title: Medical image security and EPR hiding using Shamir's secret sharing scheme

paper_content:

Medical applications such as telediagnosis require information exchange over insecure networks. Therefore, protection of the integrity and confidentiality of the medical images is an important issue. Another issue is to store electronic patient record (EPR) in the medical image by steganographic or watermarking techniques. Studies reported in the literature deal with some of these issues but not all of them are satisfied in a single method. A medical image is distributed among a number of clinicians in telediagnosis and each one of them has all the information about the patient's medical condition. However, disclosing all the information about an important patient's medical condition to each of the clinicians is a security issue. This paper proposes a (k, n) secret sharing scheme which shares medical images among a health team of n clinicians such that at least k of them must gather to reveal the medical image to diagnose. Shamir's secret sharing scheme is used to address all of these security issues in one method. The proposed method can store longer EPR strings along with better authenticity and confidentiality properties while satisfying all the requirements as shown in the results.
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paper_title: Effective Management of Medical Information Through A Novel Blind Watermarking Technique

paper_content:

Medical Data Management (MDM) domain consists of various issues of medical information like authentication, security, privacy, retrieval and storage etc. Medical Image Watermarking (MIW) techniques have recently emerged as a leading technology to solve the problems associated with MDM. This paper proposes a blind, Contourlet Transform (CNT) based MIW scheme, robust to high JPEG and JPEG2000 compression and simultaneously capable of addressing a range of MDM issues like medical information security, content authentication, safe archiving and controlled access retrieval etc. It also provides a way for effective data communication along with automated medical personnel teaching. The original medical image is first decomposed by CNT. The Low pass subband is used to embed the watermark in such a way that enables the proposed method to extract the embedded watermark in a blind manner. Inverse CNT is then applied to get the watermarked image. Extensive experiments were carried out and the performance of the proposed scheme is evaluated through both subjective and quantitative measures. The experimental results and comparisons, confirm the effectiveness and efficiency of the proposed technique in the MDM paradigm.
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paper_title: High capacity, reversible data hiding in medical images

paper_content:

In this paper we introduce a highly efficient reversible data hiding technique. It is based on dividing the image into tiles and shifting the histograms of each image tile between its minimum and maximum frequency. Data are then inserted at the pixel level with the largest frequency to maximize data hiding capacity. It exploits the special properties of medical images, where the histogram of their non-overlapping image tiles mostly peak around some gray values and the rest of the spectrum is mainly empty. The zeros (or minima) and peaks (maxima) of the histograms of the image tiles are then relocated to embed the data. The grey values of some pixels are therefore modified. High capacity, high fidelity, reversibility and multiple data insertions are the key requirements of data hiding in medical images. We show how histograms of image tiles of medical images can be exploited to achieve these requirements. Compared with data hiding method in the whole image, our scheme can result in 30%–200% capacity improvement with still better image quality, depending on the medical image content.
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paper_title: Image-Based Electronic Patient Records for Secured Collaborative Medical Applications

paper_content:

We developed a Web-based system to interactively display image-based electronic patient records (EPR) for secured intranet and Internet collaborative medical applications. The system consists of four major components: EPR DICOM gateway (EPR-GW), image-based EPR repository server (EPR-Server), Web server and EPR DICOM viewer (EPR-Viewer). In the EPR-GW and EPR-Viewer, the security modules of digital signature and authentication are integrated to perform the security processing on the EPR data with integrity and authenticity. The privacy of EPR in data communication and exchanging is provided by SSL/TLS-based secure communication. This presentation gave a new approach to create and manage image-based EPR from actual patient records, and also presented a way to use Web technology and DICOM standard to build an open architecture for collaborative medical applications
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paper_title: Reversible data hiding based on block median preservation

paper_content:

This paper proposes a reversible data hiding scheme for gray level images. It exploits the high correlation among image block pixels to produce a difference histogram. Secret data is embedded based on a multi-level histogram shifting mechanism with reference to the integer median of each block. The image blocks are divided into four categories due to four corresponding embedding strategies, aiming at preserving the medians during data embedding. In decoder, the median pixels are retrieved first followed by the hidden data extraction, and the host image can be accurately recovered via an inverse histogram shifting mechanism after removing the secret data from the marked image. Experimental results validate the effectiveness of our scheme and demonstrate that it outperforms several previous methods in terms of capacity and marked image's quality.
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paper_title: A local Tchebichef moments-based robust image watermarking

paper_content:

Protection against geometric distortions and common image processing operations with blind detection becomes a much challenging task in image watermarking. To achieve this, in this paper we propose a content-based watermarking scheme that combines the invariant feature extraction with watermark embedding by using Tchebichef moments. Harris-Laplace detector is first adopted to extract feature points, and then non-overlapped disks centered at feature points are generated. These disks are invariant to scaling and translation distortions. For each disk, orientation alignment is then performed to achieve rotation invariant. Finally, the watermark is embedded in magnitudes of Tchebichef moments of each disk via dither modulation to realize the robustness to common image processing operations and the blind detection. Thorough simulation results obtained by using the standard benchmark, Stirmark, demonstrate that the proposed method is robust against various geometric distortions as well as common image processing operations and outperforms representative image watermarking schemes.
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paper_title: Tamper Detection and Recovery for Medical Images Using Near-lossless Information Hiding Technique

paper_content:

Digital medical images are very easy to be modified for illegal purposes. For example, microcalcification in mammography is an important diagnostic clue, and it can be wiped off intentionally for insurance purposes or added intentionally into a normal mammography. In this paper, we proposed two methods to tamper detection and recovery for a medical image. A 1024 × 1024 x-ray mammogram was chosen to test the ability of tamper detection and recovery. At first, a medical image is divided into several blocks. For each block, an adaptive robust digital watermarking method combined with the modulo operation is used to hide both the authentication message and the recovery information. In the first method, each block is embedded with the authentication message and the recovery information of other blocks. Because the recovered block is too small and excessively compressed, the concept of region of interest (ROI) is introduced into the second method. If there are no tampered blocks, the original image can be obtained with only the stego image. When the ROI, such as microcalcification in mammography, is tampered with, an approximate image will be obtained from other blocks. From the experimental results, the proposed near-lossless method is proven to effectively detect a tampered medical image and recover the original ROI image. In this study, an adaptive robust digital watermarking method combined with the operation of modulo 256 was chosen to achieve information hiding and image authentication. With the proposal method, any random changes on the stego image will be detected in high probability.
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paper_title: Counterfeiting attacks on oblivious block-wise independent invisible watermarking schemes.

paper_content:

In this paper, we describe a class of attacks on certain block-based oblivious watermarking schemes. We show that oblivious watermarking techniques that embed information into a host image in a block-wise independent fashion are vulnerable to a counterfeiting attack. Specifically, given a watermarked image, one can forge the watermark it contains into another image without knowing the secret key used for watermark insertion and in some cases even without explicitly knowing the watermark. We demonstrate successful implementations of this attack on a few watermarking techniques that have been proposed in the literature. We also describe a possible solution to this problem of block-wise independence that makes our attack computationally intractable.
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paper_title: Spatial Domain- High Capacity Data Hiding in ROI Images

paper_content:

Digital watermarking, one of the data hiding techniques has become an emerging area of research due to the wide spread use of Internet and intranets. Though the watermark is used for authentication purpose, its methodology has been adapted for hiding data in many applications namely electronic patient record (EPR) data hiding in medical images. Medical images are usually large sized images and stored without loss of redundancy. Recent researches have proven that appropriate level of JPEG (joint picture expert group) compression may be used on these image types without loss of diagnostic content. This has provided an opportunity for more rapid image transmission. This work focuses on the estimation of the data hiding capacity of region of interest (ROI) medical images and optimizing the JPEG survival level that allow acceptable JPEG compression for conventional spatial domain watermarking techniques namely LSB technique, additive technique and spread spectrum technique
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paper_title: Developing a Digital Image Watermarking Model

paper_content:

This paper presents a key based generic model for digital image watermarking. The model aims at addressing an identified gap in the literature by providing a basis for assessing different watermarking requirements in various digital image applications. We start with a formulation of a basic watermarking system, and define system inputs and outputs. We then proceed to incorporate the use of keys in the design of various system components. Using the model, we also define a few fundamental design and evaluation parameters. To demonstrate the significance of the proposed model, we provide an example of how it can be applied to formally define common attacks.
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paper_title: Models of Watermarking

paper_content:

Publisher Summary ::: This chapter provides the conceptual models of watermarking. These models serve as ways of thinking about actual watermarking systems. They fall into two broad groups: models based on a view of watermarking as a method of communication and models based on geometric views of watermarking algorithms. It describes three models of watermarking systems based on the traditional model of a communications channel. These differ in how the cover Work is incorporated into the system. In the basic model, the cover Work is considered noise added during transmission of the watermark signal and in models of watermarking as communications with side information at the transmitter, the cover Work is still considered noise, but the watermark encoding process is provided with its value as side information. In models of watermarking as multiplexing, the cover Work and the watermark are considered two messages multiplexed together for reception by two different “receivers”: a human and a watermark detector, respectively. Part of a watermarking system can be viewed as an extraction process that projects or distorts media space into a marking space. The rest can then be viewed as a simpler watermarking system that operates in marking space rather than in media space. Many watermarking systems fall into the class of correlation-based systems, in which the detector uses some form of correlation as a detection metric. This is true even of many systems not explicitly described as using correlation-based detection.
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paper_title: The integration of medical images with the electronic patient record and their web-based distribution

paper_content:

Abstract Medical images are currently created digitally and stored in the radiology department’s picture archiving and communication system. Reports are usually stored in the electronic patient record of other information systems, such as the radiology information system (RIS) and the hospital information system (HIS). But high-quality services can only be provided if electronic patient record data is integrated with digital images in picture archiving and communication systems. Clinicians should be able to access both systems’ data in an integrated and consistent way as part of their regular working environment, whether HIS or RIS. Also, this system should allow for teleconferencing with other users, eg, for consultation with a specialist in the radiology department. This article describes a web-based solution that integrates the digital images of picture archiving and communication systems with electronic patient record/HIS/RIS data and has built-in teleconferencing functionality. This integration has been successfully tested using three different commercial RIS and HIS products.
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paper_title: Robust DWT-SVD domain image watermarking: embedding data in all frequencies

paper_content:

Protection of digital multimedia content has become an increasingly important issue for content owners and service providers. As watermarking is identified as a major technology to achieve copyright protection, the relevant literature includes several distinct approaches for embedding data into a multimedia element (primarily images, audio, and video). Because of its growing popularity, the Discrete Wavelet Transform (DWT) is commonly used in recent watermarking schemes. In a DWT-based scheme, the DWT coefficients are modified with the data that represents the watermark. In this paper, we present a hybrid scheme based on DWT and Singular Value Decomposition (SVD). After decomposing the cover image into four bands, we apply the SVD to each band, and embed the same watermark data by modifying the singular values. Modification in all frequencies allows the development of a watermarking scheme that is robust to a wide range of attacks.
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paper_title: Tamper detection with self-correction hybrid spatial-DCT domains image authentication technique

paper_content:

The development of effective image authentication techniques is of remarkably growing interest. Some recently developed fragile, semi-fragile/robust or hybrid-watermarking algorithms not only verify the authenticity of the watermarked image but also provide self reconstruction capabilities. However, several algorithms have been reported as vulnerable to various attacks, especially blind pattern matching attacks, with insufficient security. We propose a new blind dual-domain self-embedding watermarking scheme with more secure embedding processes of the image's blocks fragile signatures and robust approximations and more reliable local alterations detection with auto-correction capabilities, surviving normal image content preserving operations. Hence it prevents falsification, the real threat to authentication.
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paper_title: A data-hiding technique with authentication, integration, and confidentiality for electronic patient records

paper_content:

A data-hiding technique called the "bipolar multiple-number base" was developed to provide capabilities of authentication, integration, and confidentiality for an electronic patient record (EPR) transmitted among hospitals through the Internet. The proposed technique is capable of hiding those EPR related data such as diagnostic reports, electrocardiogram, and digital signatures from doctors or a hospital into a mark image. The mark image could be the mark of a hospital used to identify the origin of an EPR. Those digital signatures from doctors and a hospital could be applied for the EPR authentication. Thus, different types of medical data can be integrated into the same mark image. The confidentiality is ultimately achieved by decrypting the EPR related data and digital signatures with an exact copy of the original mark image. The experimental results validate the integrity and the invisibility of the hidden EPR related data. This newly developed technique allows all of the hidden data to be separated and restored perfectly by authorized users.
---
paper_title: Lossless ROI Medical Image Watermarking Technique with Enhanced Security and High Payload Embedding

paper_content:

In this article, a new fragile, blind, high payload capacity, ROI (Region of Interest) preserving Medical image watermarking (MIW) technique in the spatial domain for gray scale medical images is proposed. We present a watermarking scheme that combines lossless data compression and encryption technique in application to medical images. The effectiveness of the proposed scheme, proven through experiments on various medical images through various image quality measure matrices such as PSNR, MSE and MSSIM enables us to argue that, the method will help to maintain Electronic Patient Report(EPR)/DICOM data privacy and medical image integrity.
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paper_title: Security Protection of DICOM Medical Images Using Dual-Layer Reversible Watermarking with Tamper Detection Capability

paper_content:

Teleradiology applications and universal availability of patient records using web-based technology are rapidly gaining importance. Consequently, digital medical image security has become an important issue when images and their pertinent patient information are transmitted across public networks, such as the Internet. Health mandates such as the Health Insurance Portability and Accountability Act require healthcare providers to adhere to security measures in order to protect sensitive patient information. This paper presents a fully reversible, dual-layer watermarking scheme with tamper detection capability for medical images. The scheme utilizes concepts of public-key cryptography and reversible data-hiding technique. The scheme was tested using medical images in DICOM format. The results show that the scheme is able to ensure image authenticity and integrity, and to locate tampered regions in the images.
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paper_title: Robust and high-quality time-domain audio watermarking based on low-frequency amplitude modification

paper_content:

This work proposes a method of embedding digital watermarks into audio signals in the time domain. The proposed algorithm exploits differential average-of-absolute-amplitude relations within each group of audio samples to represent one-bit information. The principle of low-frequency amplitude modification is employed to scale amplitudes in a group manner (unlike the sample-by-sample manner as used in pseudonoise or spread-spectrum techniques) in selected sections of samples so that the time-domain waveform envelope can be almost preserved. Besides, when the frequency-domain characteristics of the watermark signal are controlled by applying absolute hearing thresholds in the psychoacoustic model, the distortion associated with watermarking is hardly perceivable by human ears. The watermark can be blindly extracted without knowledge of the original signal. Subjective and objective tests reveal that the proposed watermarking scheme maintains high audio quality and is simultaneously highly robust to pirate attacks, including MP3 compression, low-pass filtering, amplitude scaling, time scaling, digital-to-analog/analog-to-digital reacquisition, cropping, sampling rate change, and bit resolution transformation. Security of embedded watermarks is enhanced by adopting unequal section lengths determined by a secret key.
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paper_title: Robust Image Watermarking Based on Multiband Wavelets and Empirical Mode Decomposition

paper_content:

In this paper, we propose a blind image watermarking algorithm based on the multiband wavelet transformation and the empirical mode decomposition. Unlike the watermark algorithms based on the traditional two-band wavelet transform, where the watermark bits are embedded directly on the wavelet coefficients, in the proposed scheme, we embed the watermark bits in the mean trend of some middle-frequency subimages in the wavelet domain. We further select appropriate dilation factor and filters in the multiband wavelet transform to achieve better performance in terms of perceptually invisibility and the robustness of the watermark. The experimental results show that the proposed blind watermarking scheme is robust against JPEG compression, Gaussian noise, salt and pepper noise, median filtering, and Con-vFilter attacks. The comparison analysis demonstrate that our scheme has better performance than the watermarking schemes reported recently.
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paper_title: Robust watermarking and compression for medical images based on genetic algorithms

paper_content:

A ROI (region of interest) of a medical image is an area including important information and must be stored without any distortion. In order to achieve optimal compression as well as satisfactory visualization of medical images, we compress the ROI by lossless compression, and the rest by lossy compression. Furthermore, security is an important issue in web-based medical information system. Watermarking skill is often used for protecting medical images. In this paper, we present a robust technique embedding the watermark of signature information or textual data around the ROI of a medical image based on genetic algorithms. A fragile watermark is adopted to detect any unauthorized modification. The embedding of watermark in the frequency domain is more difficult to be pirated than in spatial domain.
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paper_title: Digital Watermarking and Steganography

paper_content:

Digital audio, video, images, and documents are flying through cyberspace to their respective owners. Unfortunately, along the way, individuals may choose to intervene and take this content for themselves. Digital watermarking and steganography technology greatly reduces the instances of this by limiting or eliminating the ability of third parties to decipher the content that he has taken. The many techiniques of digital watermarking (embedding a code) and steganography (hiding information) continue to evolve as applications that necessitate them do the same. The authors of this second edition provide an update on the framework for applying these techniques that they provided researchers and professionals in the first well-received edition. Steganography and steganalysis (the art of detecting hidden information) have been added to a robust treatment of digital watermarking, as many in each field research and deal with the other. New material includes watermarking with side information, QIM, and dirty-paper codes. The revision and inclusion of new material by these influential authors has created a must-own book for anyone in this profession. ::: ::: *This new edition now contains essential information on steganalysis and steganography ::: *New concepts and new applications including QIM introduced ::: *Digital watermark embedding is given a complete update with new processes and applications
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paper_title: Secret and public key image watermarking schemes for image authentication and ownership verification

paper_content:

We describe a watermarking scheme for ownership verification and authentication. Depending on the desire of the user, the watermark can be either visible or invisible. The scheme can detect any modification made to the image and indicate the specific locations that have been modified. If the correct key is specified in the watermark extraction procedure, then an output image is returned showing a proper watermark, indicating the image is authentic and has not been changed since the insertion of the watermark. Any modification would be reflected in a corresponding error in the watermark. If the key is incorrect, or if the image was not watermarked, or if the watermarked image is cropped, the watermark extraction algorithm will return an image that resembles random noise. Since it requires a user key during both the insertion and the extraction procedures, it is not possible for an unauthorized user to insert a new watermark or alter the existing watermark so that the resulting image will pass the test. We present secret key and public key versions of the technique.
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paper_title: BLIND DETECTION OF MALICIOUS ALTERATIONS ON STILL IMAGES USING ROBUST WATERMARKS

paper_content:

Digital image manipulation software is now readily available on personal computers. It is therefore very simple to tamper with any image and make it available to others. Insuring digital image integrity becomes a major issue. In this paper, we propose an original method to protect image authenticity using an invisible and robust watermark. Our scheme is independent of the signer, however the latter must have a high capacity and be able to extract the watermark in full blind detection mode. Our approach is based on the extraction of features from the image. These features are chosen so as to be unaffected by non malicious alterations such as lossy compression. They are embedded in the image using an iterative process so that watermarked image features and information contained in the watermark coincide perfectly. The authenticity is verified by comparing the features of the tested image, with those of the original image recovered from the watermark. (6 pages)
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paper_title: Robust Image Watermarking in the Spatial Domain

paper_content:

The rapid evolution of digital image manipulation and transmission techniques has created a pressing need for the protection of the intellectual property rights on images. A copyright protection method that is based on hiding an ‘invisible’ signal, known as digital watermark, in the image is presented in this paper. Watermark casting is performed in the spatial domain by slightly modifying the intensity of randomly selected image pixels. Watermark detection does not require the existence of the original image and is carried out by comparing the mean intensity value of the marked pixels against that of the pixels not marked. Statistical hypothesis testing is used for this purpose. Pixel modifications can be done in such a way that the watermark is resistant to JPEG compression and lowpass filtering. This is achieved by minimizing the energy content of the watermark signal at higher frequencies while taking into account properties of the human visual system. A variation that generates image dependent watermarks as well as a method to handle geometrical distortions are presented. An extension to color images is also pursued. Experiments on real images verify the effectiveness of the proposed techniques.
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paper_title: A robust watermarking scheme using self-reference image

paper_content:

In this paper, a robust watermark scheme for copyright protection is proposed. By modifying the original image in transform domain and embedding a watermark in the difference values between the original image and its reference image, the proposed scheme overcomes the weak robustness problem of embedding a watermark in the spatial domain. Besides, the watermark extraction does not require the original image so it is more practical in real application. The experimental results show that the proposed scheme provides not only good image quality, but is also robust against various attacks, such as JPEG lossy compression, filtering and noise addition.
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paper_title: A Region-Based Lossless Watermarking Scheme for Enhancing Security of Medical Data

paper_content:

This paper presents a lossless watermarking scheme in the sense that the original image can be exactly recovered from the watermarked one, with the purpose of verifying the integrity and authenticity of medical images. In addition, the scheme has the capability of not introducing any embedding-induced distortion in the region of interest (ROI) of a medical image. Difference expansion of adjacent pixel values is employed to embed several bits. A region of embedding, which is represented by a polygon, is chosen intentionally to prevent introducing embedding distortion in the ROI. Only the vertex information of a polygon is transmitted to the decoder for reconstructing the embedding region, which improves the embedding capacity considerably. The digital signature of the whole image is embedded for verifying the integrity of the image. An identifier presented in electronic patient record (EPR) is embedded for verifying the authenticity by simultaneously processing the watermarked image and the EPR. Combining with fingerprint system, patient’s fingerprint information is embedded into several image slices and then extracted for verifying the authenticity.
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paper_title: Watermarking of chest CT scan medical images for content authentication

paper_content:

Medical image is usually comprised of region of interest (ROI) and region of non interest (RONI). ROI is the region that contains the important information from diagnosis point of view so it must be stored without any distortion. We have proposed a digital watermarking technique which avoids the distortion of image in ROI by embedding the watermark information in RONI. The watermark is comprised of patient information, hospital logo and message authentication code, computed using hash function. Earlier BCH encryption of watermark is performed to ensure inaccessibility of embedded data to the adversaries.
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paper_title: Medical image security and EPR hiding using Shamir's secret sharing scheme

paper_content:

Medical applications such as telediagnosis require information exchange over insecure networks. Therefore, protection of the integrity and confidentiality of the medical images is an important issue. Another issue is to store electronic patient record (EPR) in the medical image by steganographic or watermarking techniques. Studies reported in the literature deal with some of these issues but not all of them are satisfied in a single method. A medical image is distributed among a number of clinicians in telediagnosis and each one of them has all the information about the patient's medical condition. However, disclosing all the information about an important patient's medical condition to each of the clinicians is a security issue. This paper proposes a (k, n) secret sharing scheme which shares medical images among a health team of n clinicians such that at least k of them must gather to reveal the medical image to diagnose. Shamir's secret sharing scheme is used to address all of these security issues in one method. The proposed method can store longer EPR strings along with better authenticity and confidentiality properties while satisfying all the requirements as shown in the results.
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paper_title: Medical Image Watermarking with Tamper Detection and Recovery

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This paper discussed security of medical images and reviewed some work done regarding them. A fragile watermarking scheme was then proposed that could detect tamper and subsequently recover the image. Our scheme required a secret key and a public chaotic mixing algorithm to embed and recover a tampered image. The scheme was also resilient to VQ attack. The purposes were to verify the integrity and authenticity of medical images. We used 800x600x8 bits ultrasound (US) greyscale images in our experiment. We tested our algorithm for up to 50% tampered block and obtained 100% recovery for spread-tampered block. I. INTRODUCTION Security of medical images, derived from strict ethics and legislative rules, gives rights to the patient and duties to the health professionals. This imposes three mandatory characteristics: confidentiality, reliability and availability: • Confidentiality means that only the entitled persons have access to the images; • Reliability which has two aspects; Integrity: the image has not been modified by non-authorized person, and authentication: a proof that the image belongs indeed to the correct patient and is issued from the correct source;
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paper_title: On the robustness and security of digital image watermarking

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In most of the digital image watermarking schemes, it becomes a common practice to address security in terms of robustness, which is basically a norm in cryptography. Such consideration in developing and evaluation of a watermarking scheme may severely affect the performance and render the scheme ultimately unusable. This paper provides an explicit theoretical analysis towards watermarking security and robustness in figuring out the exact problem status from the literature. With the necessary hypotheses and analyses from technical perspective, we demonstrate the fundamental realization of the problem. Finally, some necessary recommendations are made for complete assessment of watermarking security and robustness.
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paper_title: An additive and lossless watermarking method based on invariant image approximation and Haar wavelet transform

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In this article, we propose a new additive lossless watermarking scheme which identifies parts of the image that can be reversibly watermarked and conducts message embedding in the conventional Haar wavelet transform coefficients. Our approach makes use of an approximation of the image signal that is invariant to the watermark addition for classifying the image in order to avoid over/underflows. The method has been tested on different sets of medical images and some usual natural test images as Lena. Experimental result analysis conducted with respect to several aspects including data hiding capacity and image quality preservation, shows that our method is one of the most competitive existing lossless watermarking schemes in terms of high capacity and low distortion.
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paper_title: Practical analysis of watermarking capacity

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Digital watermarking embedding is a hot research field of image processing. Digital watermarking is only possible because our vision system is not perfect. A number of applications have emerged such as copyright notification, time stamp and automated monitoring. There have been ingenious works on watermarking capacity, which all assume the attack distortion are Gaussian additive distribution. We argue that these results are beautiful but not practical. It is hard to classify different attacking methods into a uniform format (especially as Gaussian distribution). In the other hand, the capacity of a given image's information is an interesting and important topic. Instead of conventional analysis based on non-precise assumption of attack distortion, this paper concentrates on the problem of how much information that image can carry without much visibility distortion. Our work is based on wavelet transform and mean-squared error since we believe they are representative measure for most work. Comparing with the former work on the watermarking capacity, this paper pays more attention to the influence on capacity of widely used technique such as spread spectrum. In the last part of this paper, we discuss future trends of new watermarking algorithm and their influence on capacity.
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paper_title: Robust Image Watermarking Based on Multiscale Gradient Direction Quantization

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We propose a robust quantization-based image watermarking scheme, called the gradient direction watermarking (GDWM), based on the uniform quantization of the direction of gradient vectors. In GDWM, the watermark bits are embedded by quantizing the angles of significant gradient vectors at multiple wavelet scales. The proposed scheme has the following advantages: 1) increased invisibility of the embedded watermark because the watermark is embedded in significant gradient vectors, 2) robustness to amplitude scaling attacks because the watermark is embedded in the angles of the gradient vectors, and 3) increased watermarking capacity as the scheme uses multiple-scale embedding. The gradient vector at a pixel is expressed in terms of the discrete wavelet transform (DWT) coefficients. To quantize the gradient direction, the DWT coefficients are modified based on the derived relationship between the changes in the coefficients and the change in the gradient direction. Experimental results show that the proposed GDWM outperforms other watermarking methods and is robust to a wide range of attacks, e.g., Gaussian filtering, amplitude scaling, median filtering, sharpening, JPEG compression, Gaussian noise, salt & pepper noise, and scaling.
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paper_title: High capacity data hiding schemes for medical images based on difference expansion

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Since the difference expansion (DE) technique was proposed, many researchers tried to, improve its performance in terms of hiding capacity and visual quality. In this paper, a new scheme, based on DE is proposed in order to increase the hiding capacity for medical images. One of the characteristics of medical images, among the other types of images, is the large smooth regions. Taking advantage of this characteristic, our scheme divides the image into two regions; smooth region and non-smooth region. For the smooth region, a high embedding capacity scheme is applied, while the original DE method is applied to the non-smooth region. Sixteen DICOM images of different modalities were used for testing the proposed schemes. The results showed that the proposed scheme has higher hiding capacity compared to the original schemes.
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paper_title: Dual watermark for image tamper detection and recovery

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An effective dual watermark scheme for image tamper detection and recovery is proposed in this paper. In our algorithm, each block in the image contains watermark of other two blocks. That is to say, there are two copies of watermark for each non-overlapping block in the image. Therefore, we maintain two copies of watermark of the whole image and provide second chance for block recovery in case one copy is destroyed. A secret key, which is transmitted along with the watermarked image, and a public chaotic mixing algorithm are used to extract the watermark for tamper recovery. By using our algorithm, a 90% tampered image can be recovered to a dim yet still recognizable condition (PSNR ~20dB). Experimental results demonstrate that our algorithm is superior to the compared techniques, especially when the tampered area is large.
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paper_title: A robust content-based digital image watermarking scheme

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This paper presents a content-based digital image-watermarking scheme, which is robust against a variety of common image-processing attacks and geometric distortions. The image content is represented by important feature points obtained by our image-texture-based adaptive Harris corner detector. These important feature points are geometrically significant and therefore are capable of determining the possible geometric attacks with the aid of the Delaunay-tessellation-based triangle matching method. The watermark is encoded by both the error correcting codes and the spread spectrum technique to improve the detection accuracy and ensure a large measure of security against unintentional or intentional attacks. An image-content-based adaptive embedding scheme is applied in discrete Fourier transform (DFT) domain of each perceptually high textured subimage to ensure better visual quality and more robustness. The watermark detection decision is based on the number of matched bits between the recovered and embedded watermarks in embedding subimages. The experimental results demonstrate the robustness of the proposed method against any combination of the geometric distortions and various common image-processing operations such as JPEG compression, filtering, enhancement, and quantization. Our proposed system also yields a better performance as compared with some peer systems in the literature.
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paper_title: Multiple watermark embedding scheme in wavelet-spatial domains based on ROI of medical images

paper_content:

Watermarking in medical images is a new area of research. It has the potential of being a value-added tool for medical confidentiality protection, patient-related information hiding, and information retrieval. Medical image watermarking requires extreme care when embedding additional data within the medical images because the additional information must not affect the image quality as this may cause misdiagnosis. In this paper we present a scheme that depends on the extraction of the ROI (region of interest) and its use as a watermark to be embedded twice; first as a robust watermark in the RONI (region of non interest) in the wavelet domain and again as a fragile watermark in the ROI in the spatial domain. Moreover multiple watermarks such as the physician's digital signature and EPR (Electronics Patient Record) are embedded in the RONI in wavelet domain depending on a private key. We compare this scheme by another one that we presented before to show the robustness of new scheme. In our work we use MRI brain images with a brain tumor as the ROI. The experimental results showed that the watermarked image is robust to JPEG compression, ROI removal, and addition of an additional tumor to the image and some geometrical attacks; lowpass and median filtering and some types of noise as; Gaussian, Poisson, Salt and Pepper and finally Speckle.
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paper_title: Authentication and Data Hiding Using a Hybrid ROI-Based Watermarking Scheme for DICOM Images

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Authenticating medical images using watermarking techniques has become a very popular area of research, and some works in this area have been reported worldwide recently. Besides authentication, many data-hiding techniques have been proposed to conceal patient’s data into medical images aiming to reduce the cost needed to store data and the time needed to transmit data when required. In this paper, we present a new hybrid watermarking scheme for DICOM images. In our scheme, two well-known techniques are combined to gain the advantages of both and fulfill the requirements of authentication and data hiding. The scheme divides the images into two parts, the region of interest (ROI) and the region of non-interest (RONI). Patient’s data are embedded into ROI using a reversible technique based on difference expansion, while tamper detection and recovery data are embedded into RONI using a robust technique based on discrete wavelet transform. The experimental results show the ability of hiding patient’s data with a very good visual quality, while ROI, the most important area for diagnosis, is retrieved exactly at the receiver side. The scheme also shows some robustness against certain levels of salt and pepper and cropping noise.
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paper_title: Multiple watermarking of medical images for content authentication and recovery

paper_content:

Medical Image data require strict security, confidentiality and integrity when transmitted from one hospital to another hospital. This can be achieved by adopting the procedures which can guarantee the image quality as well as secrecy of patient data to unauthorized users. To achieve these requirements we have proposed a multiple watermarking method. The scheme embeds robust watermark in region of non interest (RONI) for achieving security and confidentiality. While integrity control is achieved by inserting fragile watermark in region of interest ROI. Since ROI in the medical image is important from diagnosis point of view so it must be preserved. In order to avoid the distortion caused in ROI due to watermark insertion process, original ROI data is first separated and embedded outside the ROI. This will help in recovery of original ROI at the receiving end in contrast to the techniques reported in the literature which do not guarantee the integrity of the ROI after watermarking process. The image visual quality as well as tamper localization has been evaluated. We have used weighted peak signal to noise ratio (WPSNR) for measuring image quality after watermarking.
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paper_title: A Low Distorsion and Reversible Watermark: Application to Angiographic Images of the Retina

paper_content:

Medical image security can be enhanced using watermarking, which allows embedding the protection information as a digital signature, by modifying the pixel gray levels of the image. In this paper we propose a reversible watermarking scheme which guarantees that once the embedded message is read, alterations introduced during the insertion process can be removed from the image. Thereafter, original pixel gray levels of the image are restored. The proposed approach relies on estimation of image signal that is invariant to the insertion process, and permits to introduce a very slight watermark within the image. In fact, the insertion process adds or subtracts at least one gray level to the pixels of the original image. Depending on the image to be watermarked, in our case angiographic images of the retina, it is expected that such image alteration will not have any impact on the diagnosis quality, and consequently that the watermark can be kept within the image while this one is interpreted
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paper_title: Medical Image Integrity Control Combining Digital Signature and Lossless Watermarking

paper_content:

Enforcing protection of medical content becomes a major issue of computer security. Since medical contents are more and more widely distributed, it is necessary to develop security mechanism to guarantee their confidentiality, integrity and traceability in an autonomous way. In this context, watermarking has been recently proposed as a complementary mechanism for medical data protection. In this paper, we focus on the verification of medical image integrity through the combination of digital signatures with such a technology, and especially with Reversible Watermarking (RW). RW schemes have been proposed for images of sensitive content for which any modification may affect their interpretation. Whence, we compare several recent RW schemes and discuss their potential use in the framework of an integrity control process in application to different sets of medical images issued from three distinct modalities: Magnetic Resonance Images, Positron Emission Tomography and Ultrasound Imaging. Experimental results with respect to two aspects including data hiding capacity and image quality preservation, show different limitations which depend on the watermark approach but also on image modality specificities.
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paper_title: Lossless ROI Medical Image Watermarking Technique with Enhanced Security and High Payload Embedding

paper_content:

In this article, a new fragile, blind, high payload capacity, ROI (Region of Interest) preserving Medical image watermarking (MIW) technique in the spatial domain for gray scale medical images is proposed. We present a watermarking scheme that combines lossless data compression and encryption technique in application to medical images. The effectiveness of the proposed scheme, proven through experiments on various medical images through various image quality measure matrices such as PSNR, MSE and MSSIM enables us to argue that, the method will help to maintain Electronic Patient Report(EPR)/DICOM data privacy and medical image integrity.
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paper_title: A novel blind watermarking of ECG signals on medical images using EZW algorithm.

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In this paper, we present a novel blind water- marking method with secret key by embedding ECG signals in medical images. The embedding is done when the original image is compressed using the embedded zero-tree wavelet (EZW) algorithm. The extraction process is performed at the decompression time of the watermarked image. Our algorithm has been tested on several CT and MRI images and the peak signal to noise ratio (PSNR) between the original and watermarked image is greater than 35 dB for watermarking of 512 to 8192 bytes of the mark signal. The proposed method is able to utilize about 15% of the host image to embed the mark signal. This marking percentage has improved previous works while preserving the image details. transmission overheads as well as helping for computer aided diagnostics system. In this paper we present a new watermarking method combined with the EZW-based wavelet coder. The principle is to replace significant wavelet coefficients of ECG signals by the corresponding significant wavelet coefficients belong- ing to the host image which is much bigger in size than the mark signal. This paper presents a brief introduction to watermarking and the EZW coder that acts as a platform for our watermarking algorithm.
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paper_title: Multiple embedding using robust watermarks for wireless medical images

paper_content:

Within the expanding paradigm of medical imaging and wireless communications there is increasing demand for transmitting diagnostic medical imagery over error-prone wireless communication channels such as those encountered in cellular phone technology. Medical images must be compressed with minimal file size to minimize transmission time and robustly coded to withstand these wireless environments. It has been reinforced through extensive research that the most crucial regions of medical images must not be degraded and compressed by a lossless or near lossless algorithm. This type of area is called the Region of Interest (ROI). Conversely, the Region of Backgrounds (ROB) may be compressed with some loss of information to achieve a higher compression level. This type of hybrid coding scheme is most useful for wireless communication where the 'bit-budget' is devoted to the ROI. This paper also develops a way for this system to operate externally to the Joint Picture Experts Group (JPEG) still image compression standard without the use of hybrid coding. A multiple watermarking technique is developed to verify the integrity of the ROI after transmission and in the situation where there may be incidental degradation that is hard to perceive or unexpected levels of compression that may degrade ROI content beyond an acceptable level. The most useful contribution in this work is assurance of ROI image content integrity after image files are subject to incidental degradation in these environments. This is made possible with extraction of DCT signature coefficients from the ROI and embedding multiply in the ROB. Strong focus is placed on the robustness to JPEG compression and the mobile channel as well as minimizing the image file size while maintaining its integrity with the use of semi-fragile, robust watermarking.
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paper_title: Watermarking Image Authentication in Hospital Information System

paper_content:

With the broad application of electronic management of medical records, the integrality and reality authentication of medical image in hospital information system have been in front us. In order to solute these problems, a novel watermarking image authentication based on DSA is presented. In this paper, we introduce digital signature arithmetic (DSA), and analyze the advantage and shortage of DSA. Then, considering the specialty of medical image, it brings forward integrating reversible digital watermarking with digital signature to form an authentication system. Finally, the system is designed and implemented by using the c# language. The experiment results show that the medical image is difficult to tamper. It effectively solves the problem of complete integrity and reality authentication of medical image.
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paper_title: JPEG 2000 and Digital Watermarking Technique Using in Medical Image

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The Picture Archiving and Communication System(PACS) was introduced for computerization of the medical system and telediagnosis between the hospital. It is becoming possible to create, store, and transmit medical images via PACS. There has been a growing interest in protecting medical images with an enormous amount of information. To improve transmission speed among the hospitals, the medical image should be compression JPEG 2000 by high compression ratio. This paper proposes an algorithm that utilizes both JPEG 2000 and robust watermarking for protection and compression of the medical image. With the proposed algorithm, it takes considerably less time to do JPEG 2000 and watermarking than when they are done separately. Based on the experiment results, it takes 0.72 second for the proposed algorithm and 1.11 second when they are done separately. We confirmed that the proposed algorithm was faster than when they are done separately.
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paper_title: A Region-Based Lossless Watermarking Scheme for Enhancing Security of Medical Data

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This paper presents a lossless watermarking scheme in the sense that the original image can be exactly recovered from the watermarked one, with the purpose of verifying the integrity and authenticity of medical images. In addition, the scheme has the capability of not introducing any embedding-induced distortion in the region of interest (ROI) of a medical image. Difference expansion of adjacent pixel values is employed to embed several bits. A region of embedding, which is represented by a polygon, is chosen intentionally to prevent introducing embedding distortion in the ROI. Only the vertex information of a polygon is transmitted to the decoder for reconstructing the embedding region, which improves the embedding capacity considerably. The digital signature of the whole image is embedded for verifying the integrity of the image. An identifier presented in electronic patient record (EPR) is embedded for verifying the authenticity by simultaneously processing the watermarked image and the EPR. Combining with fingerprint system, patient’s fingerprint information is embedded into several image slices and then extracted for verifying the authenticity.
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paper_title: A Medical Image Authentication System Based on Reversible Digital Watermarking

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This paper discusses the security problem of integrality and reality authentication in medical image, and introduces digital signature technology based on RSA public cryptosystem in brief. It analyzes the merit and insufficiency of digital signature technology. Considering the specialty of medical image, it brings forward integrating reversible digital watermarking with digital signature to form an authentication system. Then, the scheme of the system is carried through. Finally, the system is designed and implemented by using the c# software. The experiment results show that the proposed system has good imperceptibility. It effectively solves the problem of complete integrity and reality authentication of medical image.
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paper_title: Watermarking of chest CT scan medical images for content authentication

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Medical image is usually comprised of region of interest (ROI) and region of non interest (RONI). ROI is the region that contains the important information from diagnosis point of view so it must be stored without any distortion. We have proposed a digital watermarking technique which avoids the distortion of image in ROI by embedding the watermark information in RONI. The watermark is comprised of patient information, hospital logo and message authentication code, computed using hash function. Earlier BCH encryption of watermark is performed to ensure inaccessibility of embedded data to the adversaries.
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paper_title: Lossless watermarking scheme for enhancing security of medical data in PACS

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We propose a lossless watermarking scheme, in a sense that the original image can be exactly recovered from the watermarked one, with the purpose of verifying the integrity and authenticity of medical images in PACS. Our embedding method includes imposing invertible modulations that induce low distortion level, as well as losslessly compressing the status of the original image and carrying such information in the watermarked image. Digital signature of the whole image is embedded for verifying the integrity of the image. An identifier also presented in electronic patient record (EPR) is embedded for verifying the authenticity by simultaneously processing of the watermarked image and the EPR. Combining with fingerprint system, patient’s fingerprint information is further embedded into several image slices and then extracted for verifying the authenticity. No visual quality degradation is detected in the watermarked image.
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paper_title: Clinical Assessment of Watermarked Medical Images 1

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Problem statement: Digital watermarking provides security to medical images. Watermarking in Region Of Interest (ROI) however distorts medical images but it is known that the resulting loss of fidelity is visually imperceptible. Approach: Clinical assessment will objectively evaluate the distortion on medical images to see whether or not medical diagnosis is altered. We used 75 medical images consisting of x-rays, ultrasound and CT scans. Digital watermarking was inserted in ROI and ROI/Region Of Non Interest (RONI) in all of them. Three assessors were randomly assigned 225 images, each receiving 75, a mixture of watermarked and non watermarked images. Results: Chi square test was used and p<0.05 was considered significant. There was no significant difference between original images and those watermarked in ROI or ROI/RONI. There was no comment on image quality in all the images assessed. Conclusion/Recommendations: Digital watermarking does not alter medical diagnosis when assessed by clinical radiologists. The quality of the watermarked images was also unchanged.
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paper_title: Hybrid watermarking of medical images for ROI authentication and recovery

paper_content:

Medical image data require strict security, confidentiality and integrity. To achieve these stringent requirements, we propose a hybrid watermarking method which embeds a robust watermark in the region of non-interest (RONI) for achieving security and confidentiality, while integrity control is achieved by inserting a fragile watermark into the region of the interest (ROI). First the information to be modified in ROI is separated and is inserted into RONI, which later is used in recovery of the original ROI. Secondly, to avoid the underflow and overflow, a location map is generated for embedding the watermark block-wise by leaving the suspected blocks. This avoids the preprocessing step of histogram modification. The image visual quality, as well as tamper localization, is evaluated. We use weighted peak signal to noise ratio for measuring image quality of watermarked images. Experimental results show that the proposed method outperforms the existing hybrid watermarking techniques.
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paper_title: Combination Independent Content Feature with Watermarking Annotation for Medical Image Retrieval

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The number of medical images produced in cardiology and radiology department etc. is rising strongly. New challenges arise in efficient medical data management issues, such as information retrieval and security. A novel method of combining watermarking annotation with independent content feature (ICF) for medical image retrieval is proposed. ICF is extracted by independent component analysis (ICA) to represent medical images, and the digital watermark carrying patient' information text is imperceptibly embedded. Experimental results show that the scheme employs locally salient information from medical image, and it has good retrieval performance, and watermarking algorithm used in the scheme has robustness property to the JPEG compression.
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paper_title: Data hiding in binary image for authentication and annotation

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This paper proposes a new method to embed data in binary images, including scanned text, figures, and signatures. The method manipulates "flippable" pixels to enforce specific block-based relationship in order to embed a significant amount of data without causing noticeable artifacts. Shuffling is applied before embedding to equalize the uneven embedding capacity from region to region. The hidden data can be extracted without using the original image, and can also be accurately extracted after high quality printing and scanning with the help of a few registration marks. The proposed data embedding method can be used to detect unauthorized use of a digitized signature, and annotate or authenticate binary documents. The paper also presents analysis and discussions on robustness and security issues.
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paper_title: Tamper Detection and Recovery for Medical Images Using Near-lossless Information Hiding Technique

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Digital medical images are very easy to be modified for illegal purposes. For example, microcalcification in mammography is an important diagnostic clue, and it can be wiped off intentionally for insurance purposes or added intentionally into a normal mammography. In this paper, we proposed two methods to tamper detection and recovery for a medical image. A 1024 × 1024 x-ray mammogram was chosen to test the ability of tamper detection and recovery. At first, a medical image is divided into several blocks. For each block, an adaptive robust digital watermarking method combined with the modulo operation is used to hide both the authentication message and the recovery information. In the first method, each block is embedded with the authentication message and the recovery information of other blocks. Because the recovered block is too small and excessively compressed, the concept of region of interest (ROI) is introduced into the second method. If there are no tampered blocks, the original image can be obtained with only the stego image. When the ROI, such as microcalcification in mammography, is tampered with, an approximate image will be obtained from other blocks. From the experimental results, the proposed near-lossless method is proven to effectively detect a tampered medical image and recover the original ROI image. In this study, an adaptive robust digital watermarking method combined with the operation of modulo 256 was chosen to achieve information hiding and image authentication. With the proposal method, any random changes on the stego image will be detected in high probability.
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paper_title: Data security in medical information system

paper_content:

The database systems use the mechanisms of granting and revoking privileges and of authorization control to ensure the security of data. However, some users such as administrators or persons in charge of security have access to comprehensive content of database including patient's information that are of intimate nature and must be discreet. To enhance the security and avoid illegal access of such users, we propose in this article a mechanism using the content-based watermarking technique. Patient's information are encrypted and inserted in an image associated to it. This image, with faculties of object-relational and object-oriented databases, is directly integrated into the database. To check the integrity of the image we use the edge map and invariant moments.
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paper_title: Multiple block based authentication watermarking for distribution of medical images

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To provide an effective authentication method for distribution of medical images, we propose a new fragile watermarking method utilizing segmentation information of medical image contents. For medical image modalities like CT, MRI and PET, tissue structures contain a significant amount of clinical information. Hence, it is important to provide an authenticity check of the segmented blocks. The proposed method is based on cryptographically secure fragile watermarking but eliminates the problem of the block-wise independency of existing methods. The vector quantization (VQ) counterfeiting attack is a known vulnerability due to the block-wise independency of existing methods. In our approach, multiple signatures from two different types of blocks are used to defy such attacks. More secure distribution of medical images can be achieved by embedding the watermark.
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paper_title: Detection and Restoration of a Tampered Medical Image

paper_content:

This paper presents a recoverable image tamper proofing technique using the symmetric key cryptosystem and vector quantization for detecting and restoring of a tampered medical image. Our scheme applies the one-way hashing function and the symmetric key cryptosystem to the host image to generate the verification data. To recover the tampered places, the host image is compressed by vector quantization to generate the recovery data. Once an intruder has modified the host image, our scheme can detect and recover the tampered places according to the embedded verification data and the recovery data. Besides, the proposed scheme can withstand the counterfeit attack.
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paper_title: Tamper detection with self-correction hybrid spatial-DCT domains image authentication technique

paper_content:

The development of effective image authentication techniques is of remarkably growing interest. Some recently developed fragile, semi-fragile/robust or hybrid-watermarking algorithms not only verify the authenticity of the watermarked image but also provide self reconstruction capabilities. However, several algorithms have been reported as vulnerable to various attacks, especially blind pattern matching attacks, with insufficient security. We propose a new blind dual-domain self-embedding watermarking scheme with more secure embedding processes of the image's blocks fragile signatures and robust approximations and more reliable local alterations detection with auto-correction capabilities, surviving normal image content preserving operations. Hence it prevents falsification, the real threat to authentication.
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paper_title: Multiple watermarking of medical images for content authentication and recovery

paper_content:

Medical Image data require strict security, confidentiality and integrity when transmitted from one hospital to another hospital. This can be achieved by adopting the procedures which can guarantee the image quality as well as secrecy of patient data to unauthorized users. To achieve these requirements we have proposed a multiple watermarking method. The scheme embeds robust watermark in region of non interest (RONI) for achieving security and confidentiality. While integrity control is achieved by inserting fragile watermark in region of interest ROI. Since ROI in the medical image is important from diagnosis point of view so it must be preserved. In order to avoid the distortion caused in ROI due to watermark insertion process, original ROI data is first separated and embedded outside the ROI. This will help in recovery of original ROI at the receiving end in contrast to the techniques reported in the literature which do not guarantee the integrity of the ROI after watermarking process. The image visual quality as well as tamper localization has been evaluated. We have used weighted peak signal to noise ratio (WPSNR) for measuring image quality after watermarking.
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paper_title: Medical Image Authentication Using DPT Watermarking: A Preliminary Attempt

paper_content:

Secure authentication of digital medical image content provides great value to the e-Health community and medical insurance industries. Fragile Watermarking has been proposed to provide the mechanism to authenticate digital medical image securely. Transform Domain based Watermarking are typically slower than spatial domain watermarking owing to the overhead in calculation of coefficients. In this paper, we propose a new Discrete Pascal Transform based watermarking technique. Preliminary experiment result shows authentication capability. Possible improvements on the proposed scheme are also presented before conclusions.
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paper_title: Digital watermarking of medical image using ROI information

paper_content:

Recently, the medical image has been digitized by the development of computer science and digitization of the medical devices. There are needs for database service of the medical image and long term storage because of the construction of PACS (Picture Archiving and Communication System) following DICOM (Digital Imaging Communications in Medicine) standards, telemedicine, and et al. Furthermore, authentication and copyright protection are required to protect the illegal distortion and reproduction of the medical information data. In this paper, we propose digital watermarking technique for medical image that prevents illegal forgery that can be caused after transmitting medical image data remotely. A wrong diagnosis may be occurred if the watermark is embedded into the whole area of image. Therefore, we embed the watermark into some area of medical image, except the decision area that makes a diagnosis so called region of interest (ROI) area in our paper, to increase invisibility. The watermark is the value of bit-plane in wavelet transform of the decision area for certification method of integrity verification. The experimental results show that the watermark embedded by the proposed algorithm can survive successfully in image processing operations such as JPEG lossy compression.
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paper_title: A novel watermarking technique for medical image authentication

paper_content:

Medical images are stored in PACS (picture archiving and communication systems) that are accessed over the intranet by radiologists for diagnosis. These days the trend is shifting towards a Web based interface for accessing PACS (image) data. This calls for thorough security measures in the information system of the hospital to ensure integrity of medical image data that is being transferred over the public network. The paper analyses various watermarking techniques with a perspective of applying them to medical images stored on the PACS. It discusses the applicability of invertible watermarking technique for ensuring integrity of medical images. Any modification to the watermarked DICOM (digital imaging and communications in medicine) image can be detected with high reliability using invertible fragile watermarking system. A unique content based digital signature can be generated from the image data (pixel data) which would be embedded inside the image in an imperceptible way without increasing the data size that need to be transferred. This signature can be extracted at the radiologist viewer work stations and used for the authentication while the modified pixel data is restored back to original if the image is found to be authentic. This kind of distortion free (erasable) embedding procedure would ensure image retrieval without any modification to pixel data after the authentication process that caters to the unique need of medical images for diagnosis
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paper_title: Survey of Medical Image Watermarking Algorithms

paper_content:

Watermarking in medical images is a new area of research and some works in this area have been reported world wide recently. Most of the works are on the tamper detection of the images and embedding of the Electronics Patient Record (EPR) data in the medical images. Watermarked medical images can be used for transmission, storage or telediagnosis. Tamper detection watermarks are useful to locate the regions in the image where some manipulations have been made. EPR data hiding in images improves the confidentiality of the patient data, saves memory storage space and reduce the bandwidth requirement for transmission of images. This paper discusses various aspects of medical image watermarking and makes a review of various watermarking algorithms originally proposed for medical images.
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paper_title: Security Protection of DICOM Medical Images Using Dual-Layer Reversible Watermarking with Tamper Detection Capability

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Teleradiology applications and universal availability of patient records using web-based technology are rapidly gaining importance. Consequently, digital medical image security has become an important issue when images and their pertinent patient information are transmitted across public networks, such as the Internet. Health mandates such as the Health Insurance Portability and Accountability Act require healthcare providers to adhere to security measures in order to protect sensitive patient information. This paper presents a fully reversible, dual-layer watermarking scheme with tamper detection capability for medical images. The scheme utilizes concepts of public-key cryptography and reversible data-hiding technique. The scheme was tested using medical images in DICOM format. The results show that the scheme is able to ensure image authenticity and integrity, and to locate tampered regions in the images.
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paper_title: Reversible medical image watermarking for tamper detection and recovery

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This research paper discussed the usage of watermarking in medical images to ensure the authenticity and integrity of the image and reviewed some watermarking schemes that had been developed. A design of a reversible tamper detection and recovery watermarking scheme was then proposed. The watermarking scheme uses a 640x480x8 bits ultrasound grayscale image as a sample. The concept of ROI (Region Of Interest) and RONI (Region Of Non Interest) were applied. Watermark embedded can be used to detect tampering and recovery of the image can be done. The watermark is also reversible.
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paper_title: Watermarking of chest CT scan medical images for content authentication

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Medical image is usually comprised of region of interest (ROI) and region of non interest (RONI). ROI is the region that contains the important information from diagnosis point of view so it must be stored without any distortion. We have proposed a digital watermarking technique which avoids the distortion of image in ROI by embedding the watermark information in RONI. The watermark is comprised of patient information, hospital logo and message authentication code, computed using hash function. Earlier BCH encryption of watermark is performed to ensure inaccessibility of embedded data to the adversaries.
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paper_title: Medical image integrity control seeking into the detail of the tampering

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In this paper, we propose a system which aims at verifying integrity of medical images. It not only detects and localizes alterations, but also seeks into the details of the image modification to understand what occurred. For that latter purpose, we developed an image signature which allows our system to approximate modifications by a simple model, a door function of similar dimensions. This signature is partly based on a linear combination of the DCT coefficients of pixel blocks. Protection data is attached to the image by watermarking. Whence, image integrity verification is conducted by comparing this embedded data to the recomputed one from the observed image. Experimental results with malicious image modification illustrate the overall performances of our system.
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paper_title: Authentication of digital medical images with digital signature technology.

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PURPOSE: To determine whether digital signature technology (DST) can authenticate digital medical images to the same level of authenticity required for interbank electronic transfer of funds. MATERIALS AND METHODS: Message digests were computed for two magnetic resonance images that differed only by the value of a single bit. RSA (Rivest, Shamir, and Adleman) public key cryptography was used to encrypt each message digest to form a digital signature for each image, a process analogous to the established use of RSA DST for electronic funds transfer. The process was then reversed to authenticate the original image from its digital signature. RESULTS: Although the images differed by less than 0.000095%, their message digests differed at 94% of their characters. The digital signature of the original image proved that it was authentic and that the altered image was not authentic. CONCLUSION: RSA DST can establish the authenticity of images to at least the level of confidence required for interbank electronic t...
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paper_title: Medical image security and EPR hiding using Shamir's secret sharing scheme

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Medical applications such as telediagnosis require information exchange over insecure networks. Therefore, protection of the integrity and confidentiality of the medical images is an important issue. Another issue is to store electronic patient record (EPR) in the medical image by steganographic or watermarking techniques. Studies reported in the literature deal with some of these issues but not all of them are satisfied in a single method. A medical image is distributed among a number of clinicians in telediagnosis and each one of them has all the information about the patient's medical condition. However, disclosing all the information about an important patient's medical condition to each of the clinicians is a security issue. This paper proposes a (k, n) secret sharing scheme which shares medical images among a health team of n clinicians such that at least k of them must gather to reveal the medical image to diagnose. Shamir's secret sharing scheme is used to address all of these security issues in one method. The proposed method can store longer EPR strings along with better authenticity and confidentiality properties while satisfying all the requirements as shown in the results.
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paper_title: A Semi-Reversible Watermark for Medical Image Authentication

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This paper addresses the secure storage and transmission of medical informatics in rapidly growing applications such as teleradiology and telesurgery. In particular, we propose a frequency domain digital watermarking technique that can be used to authenticate medical images in a distributed diagnosis and home healthcare environment. The most significant result of our method is the semi-reversibility property that undoes most of the degradation attributable to the watermarking process
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paper_title: Text Fusion Watermarking in Medical Image with Semi-reversible for Secure Transfer and Authentication

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Nowadays, the transmission of digitized medical information has become very convenient due to the generality of Internet. Internet has created the biggest benefit to achieve the transmission of patient information efficiently. However, it is easier that the hackers can grab or duplicate the digitized information on the Internet. This will cause the following problems of medical security and copyright protection. In order to fulfil the security and convenience issues of the patients following goals like the prevention of medical fault, the real-time detection of abnormal event, the support of clinical decision and developing of medical service based on patient has to be achieved. For this purpose this paper proposes the technique called binary embedding technique. It uses the binary information of the text embedded with semi reversible properties in the image are called binary embedding. This technique prevents the distortion of embedded information in the original image due to addition of noise. The concept of semi reversible property is used retains the original information, image quality before and after the process of watermarking is presented as a statistical analysis
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paper_title: Authentication and protection for medical image

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This paper proposes a method to authenticate and protect medical images, especially in the region of interest (ROI). The ROI of a medical image is an important area during diagnosis and must not be distorted during transmission and storage in the hospital information system. The rest of the ROI is used for embedding a watermark that contains the patients data and authentication information, and the authentication information is generated from the ROI by analyzing wavelet coefficients with singular value decomposition (SVD), before embedding the watermark into the discrete wavelet transform (DWT) sub-band. It is important that the ratio of ROI and non-ROI areas is consistent between different systems and doctors, and this ratio is analyzed in this paper. The ROI of watermarked medical image is fragile to any distortion, and patients data and authentication information can be easily extracted from non-ROI. The effectiveness of the new approach is demonstrated empirically.
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paper_title: A Novel Technique for EPR Hiding in Medical Images for Telemedicine

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Medical image data hiding has strict constrains such as high imperceptibility, high capacity and high robustness. Achieving these three requirements simultaneously is difficult. Though some works are reported in the literature on data hiding, watermarking and steganography which are suitable for telemedicine applications, none performs better in all aspects. Electronic Patient Report (EPR) data hiding for telemedicine demands a blind and reversible method. This paper proposes a novel approach to blind reversible data hiding based on integer wavelet transform. Experimental results shows that this scheme outperforms the prior arts in terms of zero BER (Bit Error Rate), higher PSNR (Peak Signal to Noise Ratio), and large EPR data embedding capacity with WPSNR (Weighted Peak Signal to Noise Ratio) around 53 dB, compared with the existing reversible data hiding schemes.
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paper_title: Lossless Watermarking in JPEG2000 for EPR Data Hiding

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With the advances in telemedicine, watermarking for Electronic Patient Record(EPR) data hiding has gained profound importance. Most of the techniques proposed for EPR data hiding are not com- pression tolerant. In this paper we propose a new lossless scheme wherein the watermark- ing is done during the JPEG2000 compression process so that both the watermark and the cover image can be recovered as such at the receiving side. The recovered image is the same as that of the decompressed image when no watermarking has been done. Keywords- JPEG2000, EPR, watermark- ing, bit-plane
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paper_title: Hybrid watermarking of medical images for ROI authentication and recovery

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Medical image data require strict security, confidentiality and integrity. To achieve these stringent requirements, we propose a hybrid watermarking method which embeds a robust watermark in the region of non-interest (RONI) for achieving security and confidentiality, while integrity control is achieved by inserting a fragile watermark into the region of the interest (ROI). First the information to be modified in ROI is separated and is inserted into RONI, which later is used in recovery of the original ROI. Secondly, to avoid the underflow and overflow, a location map is generated for embedding the watermark block-wise by leaving the suspected blocks. This avoids the preprocessing step of histogram modification. The image visual quality, as well as tamper localization, is evaluated. We use weighted peak signal to noise ratio for measuring image quality of watermarked images. Experimental results show that the proposed method outperforms the existing hybrid watermarking techniques.
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paper_title: Medical image tamper approximation based on an image moment signature

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In this paper we propose a medical image integrity verification system that not only allows detecting and localizing one alteration, but also provides an approximation of this latter. For that purpose, we suggest the embedding of an image signature or digest derived from Geometric moments of image pixel blocks. Image integrity verification is then conducted by comparing this embedded signature to the recomputed one. This signature helps to approximate modifications by determining the parameters of the nearest generalized 2D Gaussian. Experimental results with local image modification illustrate the overall performances of our method.
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paper_title: Conception and limits of robust perceptual hashing: towards side information assisted hash functions

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In this paper, we consider some basic concepts behind the design of existing robust perceptual hashing techniques for content identification. We show the limits of robust hashing from the communication perspectives as well as propose an approach that is able to overcome these shortcomings in certain setups. The consideration is based on both achievable rate and probability of error. We use the fact that most robust hashing algorithms are based on dimensionality reduction using random projections and quantization. Therefore, we demonstrate the corresponding achievable rate and probability of error based on random projections and compare with the results for the direct domain. The effect of dimensionality reduction is studied and the corresponding approximations are provided based on the Johnson-Lindenstrauss lemma. Side-information assisted robust perceptual hashing is proposed as a solution to the above shortcomings.
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paper_title: Protecting the Exchange of Medical Images in Healthcare Process Integration with Web Services

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There is now an increasing demand for sharing images and image data for process integration among healthcare institutions. Web services technology has recently been widely proposed and gradually adopted as a platform for supporting integrations. The Health Insurance Portability and Accountability Act (HIPAA) imposes rules as national standards to protect individuals' health information in the U.S., highlighting security and privacy protection requirements. There are so far no holistic solutions to tackle the various protection issues in this area, especially in inter-institutional healthcare progress integration. We propose the exchange of medical images through a medical image exchange platform (MIEP), especially replacing ad-hoc and manual exchange practices. We show how contemporary technologies of Web services and watermarking can help archive images with layered implementation architecture. Through dedicated Web services technologies with watermarking mechanism, not only can the development, deployment, and maintenance of software be streamlined, the privacy protection in medical image exchanges as required by disparate processes can also be much facilitated
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paper_title: Watermarking Is Not Cryptography

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A number of analogies to cryptographic concepts have been made about watermarking. In this paper, we argue that these analogies are misleading or incorrect, and highlight several analogies to support our argument. We believe that the fundamental role of watermarking is the reliable embedding and detection of information and should therefore be considered a form of communications. We note that the fields of communications and cryptography are quite distinct and while communications systems often combine technologies from the two fields, a layered architecture is applied that requires no knowledge of the layers above. We discuss how this layered approach can be applied to watermarking applications.
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Title: A Review of Medical Image Watermarking Requirements for Teleradiology

Section 1: Introduction
Description 1: Introduce the background and significance of medical image watermarking in teleradiology, discussing the evolution from film-based to digital imaging and the security and privacy issues involved.

Section 2: Security and Privacy Standards
Description 2: Discuss the prevailing national and international standards and legislative rules for the security and privacy of medical information, such as ISO27799, HIPAA, and DICOM.

Section 3: Medical Information Security Requirements
Description 3: Outline the security requirements for medical information in teleradiology, focusing on confidentiality, integrity, and availability. Discuss the different models of teleradiology and their security domains.

Section 4: Expected Threats and Conventional Security Measures
Description 4: Identify potential security threats to medical images and the conventional measures (firewalls, VPNs, encryption, etc.) currently used to protect them.

Section 5: Limitations of the Existing Security Measures
Description 5: Highlight the limitations of existing conventional security measures in adequately safeguarding medical images and information.

Section 6: Digital Watermarking in Teleradiology
Description 6: Introduce the concept of digital watermarking, its components, and its potential benefits for enhancing security in teleradiology systems.

Section 7: Advantages of Digital Watermarking
Description 7: Explore the various advantages of digital watermarking for medical image applications, including enhanced security, privacy, avoidance of data detachment, and memory and bandwidth savings.

Section 8: Choice of Design and Evaluation Parameters
Description 8: Discuss the critical design and evaluation parameters for developing and validating digital watermarking schemes specifically for medical images.

Section 9: Digital Watermarking Versus Other Security Measures/Tools
Description 9: Compare digital watermarking with other security measures and tools, emphasizing their relative strengths and weaknesses.

Section 10: Objectives and Applications of Watermarking for Medical Images
Description 10: Examine different objectives and specific applications of digital watermarking in medical imaging, such as origin/content authentication, EPR annotation, and tamper detection and recovery.

Section 11: Discussion and Conclusions
Description 11: Summarize the key findings of the study, discuss the implications for teleradiology, and suggest future research directions for improving security through digital watermarking.