Main Article Content
The rapid development of telemedicine services and the requirements for exchanging medical information between physicians, consultants, and health institutions have made the protection of patients’ information an important priority for any future e-health system. The protection of medical information, including the cover (i.e. medical image), has a specificity that slightly differs from the requirements for protecting other information. It is necessary to preserve the cover greatly due to its importance on the reception side as medical staff use this information to provide a diagnosis to save a patient's life. If the cover is tampered with, this leads to failure in achieving the goal of telemedicine. Therefore, this work provides an investigation of information security techniques in medical imaging, focusing on security goals. Encrypting a message before hiding them gives an extra layer of security, and thus, will provide an excellent solution to protect the sensitive information of patients during the sharing of medical information. Medical image steganography is a special case of image steganography, while Digital Imaging and Communications in Medicine (DICOM) is the backbone of all medical imaging divisions, whereby it is most broadly used to store and transmit medical images. The main objective of this study is to provide a general idea of what Least Significant Bit-based (LSB) steganography techniques have achieved in medical images.
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Nosrati M, Hanani A, Karimi R. Steganography in image segments using genetic algorithm. In 2015 Fifth International Conference on Advanced Computing & Communication Technologies:IEEE. 2015;102-107.
Sugathan S. An improved LSB embedding technique for image steganography. In 2016 2nd International Conference on Applied and Theoretical Computing and Communication Technology (iCATccT):IEEE. 2016;609-612.
Usman MA, Usman MR, Shin SY. Quality assessment for wireless capsule endoscopy videos compressed via HEVC: From diagnostic quality to visual perception. Computers in biology and medicine. 2017;91,112-134.
Thanki R, Borra S. Medical imaging and its security in telemedicine applications:Springer. 2019.
Fatehi F, Wootton R. Telemedicine, telehealth or e-health? A bibliometric analysis of the trends in the use of these terms. Journal of telemedicine and telecare. 2012;18(8), 460-464.
Sajedi H, Yaghobi SR. Information hiding methods for E-Healthcare. Smart Health. 2019;100104.
Ali NA, Khalifa O, Abd Manaf A. ICT in telemedicine: Conquering privacy and security issues in health care services. Electronic Journal of Computer Science and Information Technology: eJCIST. 2013;4(1).
Allaf AH, Kbir MA. A review of digital watermarking applications for medical image exchange security. In The proceedings of the third international conference on smart city applications:Springer, Cham. 2018;472-480.
Karakış R, Güler İ, Capraz I, Bilir E. A novel fuzzy logic-based image steganography method to ensure medical data security. Computers in biology and medicine. 2015;67 172-183.
Rani M, Deep EG. Review Paper on Digital X-Ray Image and Steganography. IJRECE. 2017;5(3), 344–348.
Thomas DS, Moorthi M, Muthalagu R. Medical image compression based on automated ROI selection for telemedicine application. Int. J. Eng. Comput. Sci. 2014;3,3638-3642.
Qasim AF, Aspin R, Meziane F, Hogg P. ROI-based reversible watermarking scheme for ensuring the integrity and authenticity of DICOM MR images. Multimedia Tools and Applications. 2019;78(12), 16433-16463.
Larobina M, Murino L. Medical image file formats. Journal of digital imaging. 2014;27(2), 200-206.
Shin HB, Sheen H, Lee HY, Kang J, Yoon DK, Suh TS. Digital imaging and communications in medicine (DICOM) information conversion procedure for SUV calculation of PET scanners with different DICOM header information. Physica Medica. 2017;44, 243-248.
Al-Haj A. Providing integrity, authenticity, and confidentiality for header and pixel data of DICOM images. Journal of digital imaging. 2015;28(2), 179-187.
Raúl RC, Claudia FU, Trinidad-BIas GDJ. Data hiding scheme for medical images. In 17th International Conference on Electronics, Communications and Computers (CONIELECOMP'07). 2007.
Qasim AF. Reversible and imperceptible watermarking approach for ensuring the integrity and authenticity of brain MR images. [Doctoral dissertation]:University of Salford. 2019.
Shini SG, Thomas T, Chithraranjan K. Cloud based medical image exchange security challenges. Procedia Engineering. 2012;38, 3454-3461.
Varma DR. Managing DICOM images: Tips and tricks for the radiologist. The Indian journal of radiology & imaging. 2012;22(1), 4.
Das S, Kundu MK. Effective management of medical information through ROI-lossless fragile image watermarking technique. Computer methods and programs in biomedicine. 2013;111(3), 662-675.
Arumugham S, Rajagopalan S, Rayappan JBB, Amirtharajan R. Networked medical data sharing on secure medium–A web publishing mode for DICOM viewer with three layer authentication. Journal of biomedical informatics 2018;86, 90-105.
Arsalan M, Qureshi AS, Khan A, Rajarajan M. Protection of medical images and patient related information in healthcare: Using an intelligent and reversible watermarking technique. Applied Soft Computing. 2017;51, 168-179.
Haas S, Wohlgemuth S, Echizen I, Sonehara N, Müller G. Aspects of privacy for electronic health records. International journal of medical informatics. 2011;80(2), e26-e31.
Fu C, Zhang GY, Bian O, Lei WM, Ma HF. A novel medical image protection scheme using a 3-dimensional chaotic system. PloS one. 2014;9(12).
Brumen B, Heričko M, Sevčnikar A, Završnik J, Hölbl M. Outsourcing medical data analyses: can technology overcome legal, privacy, and confidentiality issues?. Journal of medical Internet research 2013;15(12), e283.
Li M, Poovendran R, Narayanan S. Protecting patient privacy against unauthorized release of medical images in a group communication environment. Computerized Medical Imaging and Graphics. 2005;29(5), 367-383.
Cao F, Huang HK, Zhou XQ. Medical image security in a HIPAA mandated PACS environment. Computerized medical imaging and graphics. 2003;27(2-3), 185-196.
Ramakrishnan S. Cryptographic and Information Security Approaches for Images and Videos:CRC Press. 2018.
Idakwo MA, Muazu MB, Adedokun AE, Sadiq BO. An Extensive Survey of Digital Image Steganography: State of the Art. ATBU Journal of Science, Technology and Education. 2020;8(2), 40-54.
Elhoseny M, Ramírez-González G, Abu-Elnasr OM, Shawkat SA, Arunkumar N, Farouk A. Secure medical data transmission model for IoT-based healthcare systems:IEEE Access. 2018;6, 20596-20608.
Yahya, A. Steganography Techniques for Digital Images:Springer. 2019.
Pujari MAA, Shinde MSS. Data Security using Cryptography and Steganography. IOSR Journal of Computer Engineering. 2016;18(04), 130–139. https://doi.org/10.9790/0661-180405130139.
Kadhim IJ, Premaratne P, Vial PJ, Halloran B. Comprehensive survey of image steganography: Techniques, Evaluations, and trends in future research. Neurocomputing. 2019;335(xxxx),299– 326. https://doi.org/10.1016/j.neucom.2018.06.075.
Dhaked D, Yadav S, Mathuria M, Agrawal S. User Identification Over Digital Social Network Using Fingerprint Authentication. In Emerging Trends in Expert Applications and Security:Springer, Singapore. 2019;11-22.
Ou L, Qin Z, Yin H, Li K. Chapter 12 -Security and Privacy in Big Data. Big Data: Principles and Paradigms. 2016;285–308. https://doi.org/10.1016/B978-0-12-805394-2.00012-X.
Haddada LR, Dorizzi B, Amara NEB. A combined watermarking approach for securing biometric data. Signal Processing: Image Communication. 2017;55, 23-31.
Gupta V, Singh S. Secure Image Steganography & Digital Water Marking. 2012.
Saleh ME, Aly AA, Omara FA. Data security using cryptography and steganography techniques. IJACSA) International Journal of Advanced Computer Science and Applications. 2016;7(6), 390-397.
Asanbe M. Hybrid Data Security: A Review of Cryptography And Steganography Techniques. Villanova Journal of Science, Technology and Management, 2020;2(1).
Tripathi R, Agrawal S. Comparative study of symmetric and asymmetric cryptography techniques. International Journal of Advance Foundation and Research in Computer (IJAFRC). 2014;1(6), 68-76.
Paar C, Pelzl J. Understanding cryptography: a textbook for students and practitioners. Springer Science & Business Media. 2009.
Sheena S, Mathew S. Multimodal biometric authentication: secured encryption of iris using fingerprint ID. International Journal on Cryptography and Information Security. 2016;6(3/4), 39-46.
Lee HY. Adaptive reversible watermarking for authentication and privacy protection of medical records. Multimedia Tools and Applications. 2019;78(14), 19663-19680.
Tiwari A, Thakur YS. Multi Layer Image Steganography-Encryption mechanism employing DCT-DWT and Chaotic Network. International Journal of Applied Engineering Research. 2019;14(18), 3696-3700.
Mehta DM, Bhatti DG. Research Review on Digital Image Steganography Which Resists Against Compression. In Emerging Trends in Expert Applications and Security:Springer, Singapore. 2019;529-534.
Qadir AM, VarolN. A Review Paper on Cryptography. In 2019 7th International Symposium on Digital Forensics and Security (ISDFS):IEEE. 2019;1-6
Kannammal A, Subha Rani S. Two level security for medical images using watermarking/encryption algorithms. International Journal of Imaging Systems and Technology. 2014;24(1), 111-120.
Al-Haj A. Secured telemedicine using region-based watermarking with tamper localization. Journal of digital imaging. 2014;27(6), 737-750.
Al-Haj A, Hussein N, Abandah G. Combining cryptography and digital watermarking for secured transmission of medical images. In 2016 2nd International Conference on In-formation Management (ICIM):IEEE 2016; 40-46.
Sharma A, Singh AK, Ghrera SP. Robust and secure multiple watermarking for medical images. Wireless Personal Communications. 2017;92(4), 1611-1624.
Khond S, Vijayakumar B. Selective medical image watermarking and encryption for image security. International Journal of Pure and Applied Mathematics 2018;118(14), 191-196.
Mehta G, Dutta MK, Kim PS. Biometric data security using joint encryption and watermarking. International Journal of Electronic Security and Digital Forensics. 2019;11(4), 379-394.
Thakur S, Singh AK, Ghrera SP, Elhoseny M. Multi-layer security of medical data through watermarking and chaotic encryption for tele-health applications. Multimedia tools and Applications. 2019;78(3), 3457-3470.
Singla G, Singh C. A Review on Steganography Data Hiding using Color Images. 2019.
Atee HA, Ahmad R, Noor NM, Ilijan AK. A combined crypto-stego system using dynamic encryption assisted intensity color steganography. International Journal of Control Theory and Applications. 2016;9(30), 175–184.
Pandey R, Singh AK, Kumar B, Mohan A. Iris based secure NROI multiple eye image watermarking for teleophthalmology. Multimedia Tools and Applications. 2016;75(22), 14381-14397.
Trehan M, Mittu S. Steganography and cryptography approaches combined using medical digital images. International Journal of Engineering Research & Technology (IJERT). 2015;4.
Jain M, Lenka SK. Diagonal queue medical image steganography with Rabin cryptosystem. Brain informatics. 2016;3(1), 39-51.
Khalil MI. Medical image steganography: study of medical image quality degradation when embedding data in the frequency domain. International Journal of Computer Network and Information Security. 2017;9(2), 22.
Banjan N, Dalvi P. Medical Data Security using combination of Cryptography and Steganography with AES-LSB algorithm. 2018;7(7), 31–45.
Babatunde AO, Taiwo AJ, Dada EG. Information Security in Health Care Centre Using Cryptography and Steganography. 2018. arXiv preprint arXiv:1803.05593.
Gulia S, Mukherjee S, Choudhury T. An extensive literature survey on medical image steganography. CSI transactions on ICT. 2016;4(2-4), 293-298.
Yüksel B, Küpçü A, Özkasap Ö. Research issues for privacy and security of electronic health services. Future Generation Computer Systems. 2017;68, 1-13.
Manivannan M, Suseendran G. A Review of Watermarking Requirements, Techniques, Documents, Human Perception and Applications for Medical Images.
Santhi G, Adithya B. A Survey on Medical Image Protection Using Various Steganography Techniques. Advances in Natural and Applied Sciences. 2017;11(12), 89-94.
Atawneh S, Almomani A, Sumari P. Steganography in digital images: Common approaches and tools. IETE Technical Review. 2013;30(4), 344-358.
Aparna P, Kishore PVV. An efficient medical image watermarking technique in E-healthcare application using hybridization of compression and cryptography algorithm. Journal of Intelligent Systems. 2018;27(1), 115-133.
Luo XY, Wang DS, Wang P, Liu FL. A review on blind detection for image steganography. Signal Processing. 2008;88(9), 2138-2157.
Khalind OS. New methods to improve the pixel domain steganography, steganalysis, and simplify the assessment of steganalysis tools. [Doctoral dissertation]:University of Ports-mouth. 2015.
Rashid RD. Robust Steganographic Techniques for Secure Biometric-based Remote Authentication. [Doctoral dissertation]:University of Buckingham. 2015.
Rashid A, Salamat N, Prasath V. An algorithm for data hiding in radiographic images and ePHI/R application. Technologies. 2018;6(1), 7.
Nyeem H, Boles W, Boyd C. A review of medical image watermarking requirements for teleradiology. Journal of digital imaging. 2013;26(2), 326-343.
Konyar MZ, Öztürk S. Reed Solomon Coding-Based Medical Image Data Hiding Method against Salt and Pepper Noise. Symmetry. 2020;12(6), 899.
Karmakar R, Basu A. Implementation of a Reversible Watermarking Technique for Medical Images. In Intelligent Innovations in Multimedia Data Engineering and Management:IGI Global. 2019;1-37.
Al-Dmour HST. Enhancing information hiding and segmentation for medical images using novel steganography and clustering fusion techniques. [Doctoral dissertation]. 2018.
Thiyagarajan P, Aghila G. Reversible dynamic secure steganography for medical image using graph coloring. Health Policy and Technology. 2013;2(3), 151-161.
Langer SG. Challenges for data storage in medical imaging research. Journal of digital imaging. 2011;24(2), 203-207.
Abdulwahedand MN, Mustafa ST, Rahim MSM. Image Spatial Domain Steganography: A study of Performance Evaluation Parameters. In 2019 IEEE 9th International Conference on System Engineering and Technology (ICSET):IEEE. 2019;309-314.
Roy R, Changder S. Quality evaluation of image steganography techniques: a heuristics based approach. International Journal of Security and Its Applications. 2016;10(4), 179-196.
Kanan HR, Nazeri B. A novel image steganography scheme with high embedding capacity and tunable visual image quality based on a genetic algorithm. Expert Systems with Applications. 2014;41(14), 6123-6130.
Al-Dmour H, Al-Ani A. Quality optimized medical image information hiding algorithm that employs edge detection and data coding. Computer methods and programs in biomedicine. 2016;127, 24-43.
Parah SA, Sheikh JA, Ahad F, Loan NA, Bhat GM. Information hiding in medical images: a robust medical image watermarking system for E-healthcare. Multimedia Tools and Applications. 2017;76(8), 10599-10633.
Fkirin A, Attiya G, El-Sayed A. Steganography Literature Survey, Classification and Comparative Study. Communications on Applied Electronics. 2016;5(10), 13-22.
Rai P, Gurung S, Ghose MK. Analysis of image steganography techniques: a survey. International Journal of Computer Applications. 2015;114(1).
Anandpara D, Kothari A. Working and comparative analysis of various spatial based image steganography techniques. International Journal of Computer Applications. 2015;113(12).
Samidha D, Agrawal D. Random image steganography in spatial domain. In 2013 International Conference on Emerging Trends in VLSI, Embedded System, Nano Electronics and Telecommunication System (ICEVENT):IEEE. 2013;1-3.
Bharti J, Solanki S, Beliya A. Comparison of LSB methods and pattern. In 2017 International Conference on Recent Innovations in Signal Processing and Embedded Systems (RISE):IEEE. 2017;250-256. IEEE.
Kumar R, Murti PR. Data security and authentication using steganography. 2011.
Zeki AM, Manaf AA. A novel digital watermarking technique based on ISB (Intermediate Significant Bit). World Academy of Science, Engineering and Technology. 2009;50, 989-996.
Shet KS, Aswath AR, Hanumantharaju MC, Gao XZ. Design and development of new reconfigurable architectures for LSB/multi-bit image steganography system. Multimedia Tools and Applications. 2017;76(11), 13197-13219.
Bremnavas I, Poorna B, Kanagachidambaresan GR. Medical image security using LSB and Chaotic Logistic Map. 2011.
Martiri E, Baxhaku A, Barolli E. Steganographic algorithm injection in image information systems used in healthcare organizations. In 2011 Third International Conference on Intelligent Networking and Collaborative Systems:IEEE. 2011;408-411).
Nagaraju C, ParthaSarathy SS. Embedding ECG and patient information in medical image. In International Conference on Recent Advances and Innovations in Engineering (ICRAIE-2014):IEEE. 2014;1-6.
Naidu CD, Koppu S, Viswanatham VM, Aarthy SL. Cryptography Based Medical Image Security with LSB Blowfish Algorithms. ARPN Journal of Engineering and Applied Sciences. 2014;9(8).
Mantos PL, Maglogiannis I. Sensitive patient data hiding using a ROI reversible steganography scheme for DICOM images. Journal of medical systems. 2016;40(6), 156.
Jain M, Choudhary RC, Kumar A. Secure medical image steganography with RSA cryptography using decision tree. In 2016 2nd International Conference on Contemporary Computing and Informatics (IC3I):IEEE. 2016;291-295.
Santhi B, Dheeptha B. A novel edge based embedding in medical images based on unique key generated using sudoku puzzle design. SpringerPlus. 2016;5(1), 1670.
Jain M, Kumar A, Choudhary RC. Improved diagonal queue medical image steganography using Chaos theory, LFSR, and Rabin cryptosystem. Brain informatics. 2017;4(2), 95-106.
Manisha S, Sharmila TS. Recognition of Characters in a Securely Transmitted Medical Image. In International conference on Computer Networks, Big data and IoT:Springer, Cham. 2018;286-292.
Hyma J, Sudamalla M, Vanaparthi DT, Vinnakota K, Choppavarapu VK. A New Frame-work for Secure Outsourcing of Medical Data. In Intelligent Manufacturing and Energy Sustainability:Springer, Singapore. 2020;759-767.
Mondal J, Swain D. A 3-layer RDH method in encrypted domain for medical information security. International Journal of Electronic Security and Digital Forensics. 2020;12(1), 1-15.
Devi S, Sahoo MN, Muhammad K, Ding W, Bakshi S. Hiding medical information in brain MR images without affecting accuracy of classifying pathological brain. Future Generation Computer Systems. 2019;99, 235-246.