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An enhanced security framework for secured transfer of DICOM images by ensuring the CIA triad.

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Title: An enhanced security framework for secured transfer of DICOM images by ensuring the CIA triad.
Authors: Sharma, Prateek1 (AUTHOR) sharma.pratik2000@gmail.com, Kiron, Sneha Prem1 (AUTHOR) snehaprem.kiron@gmail.com, Aju, D.1 (AUTHOR) daju@vit.ac.in, Lal, Anisha M.1 (AUTHOR) anishamlal@vit.ac.in
Source: Multimedia Tools & Applications. Oct2025, Vol. 84 Issue 34, p43369-43394. 26p.
Subjects: Dicom (Computer network protocol), Internet security, Data protection, Medical databases, Encoding, Anonymity, Data encryption, Security systems
Abstract: With the advent of modern medicine, the speed of treatment is of paramount importance. Interconnection of medical equipment allows faster testing and reporting and allows patients and doctors to view reports from anywhere in the world. To facilitate this interconnection, the DICOM standard was proposed in 1985, to handle medical images in an efficient and effective way. However, there is now a need for these machines to be connected to the internet, and this has bought about many new threats to the security of medical data. In the last five years, a large number of cybersecurity incidents have occurred in the medical field targeting DICOM images. Since the DICOM standard does not enforce security, a framework which improves the confidentiality, authentication, and integrity for the header and pixel data during transmission, through cryptographic, watermarking and anonymization techniques is proposed in this literature. The cryptographic techniques use AES in Galois/Counter Mode (GCM), and the hashes for watermarking are generated using SHA. To protect the patients' privacy and reliability in diagnosis and treatment, the security triad CIA has been ensured in the proposed work through anonymization, hashing, encryption, timely access, and backup. It is observed that the time difference between SHA3 and SHA2 hashing are almost negligible (< 2% in worst case), when smaller workloads are performed with the modern architectures. And it is always better to prefer SHA3 when hardware acceleration is available (< 0.4% in worst case) for processing. The anonymization techniques allow DICOM image metadata to be stripped from the files in case they are to be published publicly. Overall, the proposed framework offers a robust solution to mitigate cybersecurity risks associated with DICOM image transmission, ensuring the confidentiality, authentication, and integrity of medical data in transit. By comparing with the other existing methods, it is noted that the proposed method achieves a structured similarity index of 0.9999 and the peak-signal-to-noise ratio of 79.58. [ABSTRACT FROM AUTHOR]
Copyright of Multimedia Tools & Applications is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: An enhanced security framework for secured transfer of DICOM images by ensuring the CIA triad.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Sharma%2C+Prateek%22&quot;&gt;Sharma, Prateek&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; sharma.pratik2000@gmail.com&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Kiron%2C+Sneha+Prem%22&quot;&gt;Kiron, Sneha Prem&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; snehaprem.kiron@gmail.com&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Aju%2C+D%2E%22&quot;&gt;Aju, D.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; daju@vit.ac.in&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Lal%2C+Anisha+M%2E%22&quot;&gt;Lal, Anisha M.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; anishamlal@vit.ac.in&lt;/i&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Multimedia+Tools+%26+Applications%22&quot;&gt;Multimedia Tools &amp; Applications&lt;/searchLink&gt;. Oct2025, Vol. 84 Issue 34, p43369-43394. 26p.
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  Data: With the advent of modern medicine, the speed of treatment is of paramount importance. Interconnection of medical equipment allows faster testing and reporting and allows patients and doctors to view reports from anywhere in the world. To facilitate this interconnection, the DICOM standard was proposed in 1985, to handle medical images in an efficient and effective way. However, there is now a need for these machines to be connected to the internet, and this has bought about many new threats to the security of medical data. In the last five years, a large number of cybersecurity incidents have occurred in the medical field targeting DICOM images. Since the DICOM standard does not enforce security, a framework which improves the confidentiality, authentication, and integrity for the header and pixel data during transmission, through cryptographic, watermarking and anonymization techniques is proposed in this literature. The cryptographic techniques use AES in Galois/Counter Mode (GCM), and the hashes for watermarking are generated using SHA. To protect the patients&#39; privacy and reliability in diagnosis and treatment, the security triad CIA has been ensured in the proposed work through anonymization, hashing, encryption, timely access, and backup. It is observed that the time difference between SHA3 and SHA2 hashing are almost negligible (&lt; 2% in worst case), when smaller workloads are performed with the modern architectures. And it is always better to prefer SHA3 when hardware acceleration is available (&lt; 0.4% in worst case) for processing. The anonymization techniques allow DICOM image metadata to be stripped from the files in case they are to be published publicly. Overall, the proposed framework offers a robust solution to mitigate cybersecurity risks associated with DICOM image transmission, ensuring the confidentiality, authentication, and integrity of medical data in transit. By comparing with the other existing methods, it is noted that the proposed method achieves a structured similarity index of 0.9999 and the peak-signal-to-noise ratio of 79.58. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Multimedia Tools &amp; Applications is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1007/s11042-025-20849-4
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        Text: English
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              Text: Oct2025
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