Medical Image Integrity Control Combining Digital Signature and Lossless Watermarking

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.