With the rapid development of smart medical care, copyright security for medical images is becoming increasingly important. To improve medical images storage and transmission safety, this paper proposes a robust zero-watermarking algorithm for medical images by fusing Dual-Tree Complex Wavelet Transform (DTCWT), Hessenberg decomposition, and Multi-level Discrete Cosine Transform (MDCT). First, the low-frequency sub-band of the medical image is obtained through the DTCWT and MDCT. Then Hessenberg decomposition is used to construct the visual feature vector. Meanwhile, the encryption of the watermarking image by combining cryptographic algorithms, third-party concepts, and chaotic sequences enhances the algorithm’s security. In the proposed algorithm, zero-watermarking technology is utilized to assure the medical images’ completeness. Compared with the existing algorithms, the proposed algorithm has good robustness and invisibility and can efficiently extract the watermarking image and resist different attacks.
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