Zero-Trust Medical Image Sharing: A Secure and Decentralized Approach Using Blockchain and the IPFS

The secure and efficient storage and sharing of medical images have become increasingly important due to rising security threats and performance limitations in existing healthcare systems. Centralized systems struggle to provide adequate privacy, rapid access, and reliable storage for sensitive medical images. This paper proposes a decentralized medical image-sharing framework to address these issues by integrating blockchain technology, the InterPlanetary File System (IPFS), and edge computing. Blockchain technology enforces secure patient-centric access control through smart contracts that enable patients to directly manage their data-sharing permissions. The IPFS provides decentralized and scalable storage for medical images and effectively resolves the storage limitations associated with blockchain. Edge computing enhances system responsiveness by significantly reducing latency through local data processing to ensure timely medical image access. Robust security is ensured by using elliptic curve cryptography (ECC) for secure key management and the Advanced Encryption Standard (AES) for encrypting medical images to protect against unauthorized access and data breaches. Additionally, the system includes real-time monitoring to promptly detect and respond to unauthorized access attempts to ensure continuous protection against potential security threats. System results demonstrate that the proposed framework achieves lower latency, higher throughput, and improved security compared to traditional centralized storage solutions, which makes our system suitable for practical deployment in modern healthcare settings.