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Secure communication of medical images is essential to telemedicine. Message Authentication Codes (MAC) can be embedded inside medical images to protect their integrity. Fragile watermarking algorithms are suitable options since they can be used to detect any tampering attempt. In this paper, a novel fragile data-hiding algorithm based on Integer-to-Integer Discrete Wavelet Transforms (IIDWT) and <inline-formula> <tex-math notation="LaTeX">$A_{5}$ </tex-math></inline-formula> Lattice Vector Quantization (LVQ) is proposed. In the proposed data-hiding algorithm, a combination of the medical image Metadata and a MAC is embedded into the medical image. The Metadata includes information about the patient such as name, family, birthday, the place where it is created such as the name of the hospital, and the physician&#x2019;s name. To preserve the privacy of the patients and the physician/hospital, the Metadata is then replaced with fake information. The receiver can extract the Metadata and the MAC. If the extracted MAC is the same as the expected MAC, the integrity of the medical image is guaranteed. Otherwise, a tampering attempt is detected. The proposed algorithm can embed 50&#x0025; more data than similar algorithms in medical images while keeping the Peak Signal to Noise Ratio (PSNR) in acceptable ranges. Furthermore, the proposed algorithm is applied to a dataset of medical images and high PSNR values above 53.88 dB are experienced.

Secure Medical Image Communication Using Fragile Data Hiding Based on Discrete Wavelet Transform and A₅ Lattice Vector Quantization