Seamless integration of watermarks in DICOM images

This paper proposes a watermarking method that can be applied to DICOM images to strengthen its security and privacy. A robust watermark is used to improve the identification/authentication of the image, even if it has been seriously modified, semifragile watermarks are used to embed information intended to vanish if the image losses its clinical/research value, and fragile watermarks are used to detect and locate tampering. The watermarks embed selected DICOM fields, replacing the original values with the corresponding access keys, conveniently protected with Cryptographic Message Syntax. This watermarking does not distort the image, presents a good robustness-capacity tradeoff, operates fast and is highly compatible with the JPEG2000 compressor.