Intermediate significant Bits embedding for Telemedicine applications

With the increase in telemedicine applications, data authenticity has been one of the major concerns for the received information to confirm the exact diagnosis of the diseases. This paper proposes a fragile watermarking scheme to authenticate medical images to address this. The proposed method utilizes the medical images' two (ISBs) Intermediate Significant Bits for embedding secret data and a fragile watermark. Specifically, the gray-scale fragile watermark of the (EPR) electronic patient report is embedded in the first ISB of the pixel, and secret data is embedded in the second ISB. This dual embedding enhances the authenticity of the images while maintaining low computational complexity compared to other methods. The proposed scheme achieves an average PSNR of 57.68 dB and an SSIM of 0.9990, demonstrating superior fidelity and tamper detection capabilities. These results confirm the method's potential for secure telemedicine applications.