Region-based hybrid medical image watermarking for secure telemedicine applications

In this paper we propose a novel region based hybrid medical image watermarking (MIW) scheme to ensure authenticity, integrity and confidentiality of medical images. In this scheme a digital medical image is partitioned into region of interest (ROI) and the region of non interest (RONI). To detect and localize ROI tampering with high accuracy pixel wise positional and relational bits are calculated. Positional bit is calculated with respect to MSBs, row and column of the pixel. Relational bit shows the relation between MSBs. Two original LSBs of each ROI pixel are replace by their corresponding positional and relational bits. Original LSBs of ROI pixels are concatenated and embedded in RONI for ROI recovery in the case of tampering. Multiple watermarks i. e. electronic patient record (EPR), hospitals logo and LSBs of ROI are embedded simultaneously as a robust watermark in RONI using IWT-SVD hybrid transform. The proposed scheme is blind and free from false positive detection. Various experiments have been carried out on different medical imaging modalities to evaluate the performance of the proposed scheme in terms of imperceptibility, robustness, tamper detection, localization, recovery and computation time. ROI tampering is detected and recovered with high accuracy. Thus, the proposed scheme is effective in telemedicine applications.