Health Record Security Through Multiple Watermarking on Fused Medical Images

Nowadays, there is an increasing tendency to fuse multi-modal medical image due to the high diagnostic accuracy and assessment. However, the distribution of these images and more generally, health records may bring serious copy-violation issues in healthcare applications. Further, a massive amount of electronic health records is uploaded on the cloud due to the low cost and high usability. However, outsourcing these records to the cloud may greatly increase security and privacy issues. The present article develops medical image fusion-based watermarking scheme in dual tree complex wavelet transform (DTCWT)-singular value decomposition (SVD) domain. Here, computed tomography (CT) and magnetic resonance imaging (MRI) images are partitioned into a sequence of high frequencies and low frequency by non-subsampled shearlet transform (NSST) to obtain a fused image as a carrier. To enhance the authenticity, spatial and transform domain-based embedding is conducted to conceal multi-marks into carrier image. Finally, improved encryption scheme is employed to obtain a secure marked carrier image. Objective and subjective evaluations indicate a strong robustness effect (43.64%) of the proposed algorithm compared to other methods with remarkable invisibility, payload, and security. To the best of our knowledge, studies of image fusion-based dual watermarking and encryption have not yet been developed in combination with spatial and transform domain schemes for copy protection and ownership of health records, since it is also suitable for applications in the cloud.