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During medical treatment, personal privacy is involved and must be protected. Healthcare institutions have to keep medical images or health information secret unless they have permission from the data owner to disclose them. Reversible data hiding (RDH) is a technique that embeds metadata into an image and can be recovered without any distortion after the hidden data have been extracted. This work aims to develop a fully reversible two-bit embedding RDH algorithm with a large hiding capacity for medical images. Medical images can be partitioned into regions of interest (ROI) and regions of noninterest (RONI). ROI is informative with semantic meanings essential for clinical applications and diagnosis and cannot tolerate subtle changes. Therefore, we utilize histogram shifting and prediction error to embed metadata into RONI. In addition, our embedding algorithm minimizes the side effect to ROI as much as possible. To verify the effectiveness of the proposed approach, we benchmarked three types of medical images in DICOM format, namely X-ray photography (X-ray), computer tomography (CT), and magnetic resonance imaging (MRI). Experimental results show that most of the hidden data have been embedded in RONI, and the performance achieves high capacity and leaves less visible distortion to ROIs.

Two-Bit Embedding Histogram-Prediction-Error Based Reversible Data Hiding for Medical Images with Smooth Area