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Increased growth of information technology in healthcare has led to a situation where the security of patient information is more important and is a critical issue. The aim of the proposed algorithm is to provide a framework to verify the integrity of the medical images. In this paper, the integrity of the medical images is verified by embedding hash signatures using the sequential square embedding technique. This technique is as efficient as the diamond encoding technique but with increased payload capability. The medical image is first divided into the region of interest (ROI) block and the signature block. The hash signatures are determined by dividing the ROI into nonoverlapping blocks. During the data hiding stage, the hash signatures are embedded in randomly chosen pixel pairs in the signature block using the sequential square encoding (SSE) technique. In the experimental results, the data hiding capacity of the proposed SSE technique is verified in terms of peak signal-to-noise ratio. Also, the medical image integrity is substantiated by comparing the L2 norm between computed and extracted hash signatures. Modifications such as contrast enhancement, rotation, scaling, and changing the image information result in increased L2 norm; thus, the integrity of the medical images can be verified. The parameters required for embedding, such as the embedding parameter and the seed for random sequence generation, are encrypted and communicated to the receiving end. Hence, the proposed algorithm provides a secure framework for medical image integrity verification.

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