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In order to enhance the security of exchanged medical images in telemedicine, we propose in this paper a blind and robust approach for medical image protection. This approach consists in embedding patient information and image acquisition data in the image. This imperceptible integration must generate the least possible distortion. The watermarked image must present the same clinical reading as the original image. The proposed approach is applied in the frequency domain. For this purpose, four transforms were used: discrete wavelets transform, non-subsampled contourlet transform, non-subsampled shearlet transform and discreet cosine transform. All these transforms was combined with Schur decomposition and the watermark bits were integrated in the upper triangular matrix. To obtain a satisfactory compromise between robustness and imperceptibility, the integration was performed in the medium frequencies of the image. Imperceptibility and robustness experimental results shows that the proposed methods maintain a high quality of watermarked images and are remarkably robust against several conventional attacks. Keywords Medical image Á Digital watermarking Á Discrete wavelet transform Á Non-subsampled contourlet transform Á Non-subsampled shearlet transform Á Discreet cosine transform Á Schur decomposition

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The goal of this work is to protect as much as possible the images exchanged in telemedicine, to avoid any confusion between the patient’s radiographs, these images are watermarked with the patient’s information as well as the acquisition data. Thus, during the extraction, the doctor will be able to affirm with certainty that the images belong to the treated patient. The ultimate goal of our completed work is to properly integrate the watermark with as little distortion as possible to typically retain the medical information in the image. In this innovative approach used DWT decomposition is appropriately applied to the image which allows a remarkably satisfactory adjustment during the insertion. An SVD is then applied to the three subbands LL, LH and HL, which ideally allows retaining the maximum energy of the used image in a guaranteed minimum of singular values. A specific combination of the three resulting singular value matrices is then performed for watermark integration. The proposed approach ensures data integrity, patient confidentiality when sharing data, and robustness to several conventional attacks.