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IET Quantum Communication

Enhancing Medical Image Security Leveraging Quantum Key Distribution

Sudip Shrestha, Dilip Rai, Nanda Bikram Adhikari

Published Jan 1, 2026• 1 citation
Publisher

Abstract

ABSTRACT The rapid development of healthcare system has increased the necessities for the secure medical image transmission. As quantum computers develop, classical cryptographic techniques become vulnerable to quantum attacks. This paper proposes QKD assisted quantum encryption for medical images. BB84 protocol is utilised to generate a secure shared key, which is further enhanced using Henon maps. The logistic map whose parameters are derived from the shared key is employed to generate the permutation sequence for pixel values. Medical images are encoded using the novel enhanced quantum representation (NEQR) and encrypted via quantum permutation and quantum XOR operations employing block‐wise strategy. The proposed method was evaluated in both ideal and noisy quantum environments such as amplitude damping, depolarising, bit‐flip and phase damping noise models. The experimental results show strong security performance on a benchmark and medical images with high entropy values, near zero‐pixel correlation and resistance to differential attacks. Additionally, noise analysis shows that bit‐flip and amplitude damping noises affect the image reconstruction more than phase damping and depolarising noise. Overall, the proposed framework provides a secure solution for medical image security.

DOI
10.1049/qtc2.70040

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ABSTRACT The rapid development of healthcare system has increased the necessities for the secure medical image transmission. As quantum computers develop, classical cryptographic techniques become vulnerable to quantum attacks. This paper proposes QKD assisted quantum encryption for medical images. BB84 protocol is utilised to generate a secure shared key, which is further enhanced using Henon maps. The logistic map whose parameters are derived from the shared key is employed to generate the permutation sequence for pixel values. Medical images are encoded using the novel enhanced quantum representation (NEQR) and encrypted via quantum permutation and quantum XOR operations employing block‐wise strategy. The proposed method was evaluated in both ideal and noisy quantum environments such as amplitude damping, depolarising, bit‐flip and phase damping noise models. The experimental results show strong security performance on a benchmark and medical images with high entropy values, near zero‐pixel correlation and resistance to differential attacks. Additionally, noise analysis shows that bit‐flip and amplitude damping noises affect the image reconstruction more than phase damping and depolarising noise. Overall, the proposed framework provides a secure solution for medical image security.
Abstract Ensuring the security and privacy of patient data in e‐healthcare systems that rely on cloud computation is of utmost importance. Traditional encryption is no longer resistant to quantum attacks and safeguards sensitive medical images. To tackle this issue, robust security countermeasures are proposed by integrating quantum encryption with a cloud‐based healthcare system. The encryption scheme utilizes the Generalized Novel Enhancement Quantum Representation (GNEQR) and the Novel Enhancement Quantum Representation (NEQR) to provide a framework for representing color and grayscale healthcare images. The proposed quantum algorithm uses quantum logic for image scrambling, which is combined with the encryption key by the Xor quantum gate. The encryption key is generated by 9D chaotic and permutated before encryption. Finally, channel re‐ordering is applied for color images. The simulation results for 15 medical tests with an encryption key space >2600 on a developed e‐healthcare system demonstrate the effectiveness and reliability of the proposed work where the average number of pixels change rates was 99.82, while the unified average change intensity rate was 33.51, entropy was 7.9, the horizontal, vertical, and diagonal correlation coefficients averaged 0.000533333, 0.000706667, and 0.00076, respectively. Finally, the mean squared error (MSE) between the original and encrypted images was 10203.72. These findings improve digital healthcare by revealing the solutions' performance, security, and efficacy.
Quantum key distribution (QKD) is a viable technique for safeguarding image transmission against numerous attacks. To address the limitations of existing methods in securing electronic medical records, we have explored an encryption technique using a set of real-time medical images along with existing standard images using QKD protocols including BB84 (Bennett-Brassard 1984), CASCADE (Cascading Error Correction Algorithm for Data Exchange), and differential-phase-shift (DPS) under the fiber-based (OFC) and free-space (FSO) channels. It utilizes the quantum bit-plane representation of the Real Ket (QBRK) model and a logistic chaotic system with XOR operation. The performance of the developed framework is tested via visual illustration and 11 different quantitative assessments. The average entropy of the scrambled image for the medical source image is 7.9896, which is quite near to the optimum value of 8. TheUACI(Unified Averaged Changed Intensity) and theNPCR(Number of Pixels Change Rate) metrics values lie between 33.7879 to 33.9711 and 99.6014 to 99.8000 for the FSO channel. The BB84 QKD protocol achieves a QBER (Quantum Bit Error Rate) of 0.0028 for an FSO channel with DCR (Dark Count Rate), which improves to 0.0012 when DCR is ignored for a 10 km link range. In addition, we analyzed and compared the effect of OFC on system output as the quantum channel. From several experiments, it is observed that the BB84 provides better results against CASCADE and DPS. The proposed work is validated using the Optisystem 15.1 software under FSO and for OFC.
ABSTRACT The emergence of quantum computing has introduced unprecedented security challenges to conventional cryptographic systems, particularly in the domain of classical communications. Our research addresses these challenges by creatively combining quantum key distribution (QKD), specifically the E91 protocol, with logistic chaotic maps to establish a secure image transmission scheme. Our approach utilises the pseudo‐randomness of chaotic systems alongside the security mechanisms inherent in quantum entanglement‐based protocols. This framework leverages the E91 protocol for secure quantum key distribution to generate identical key pairs at both ends, followed by chaos encryption using the key as a basis for the parameters. This framework utilises the E91 protocol for secure quantum key distribution, leveraging maximally entangled pairs and CHSH inequality tests to detect eavesdropping and potential double‐agent attacks by identifying nonentangled qubits, therefore maintaining key confidentiality. Furthermore, through quantitative simulations, we demonstrate the effectiveness of this scheme through key space and key sensitivity analysis, histogram analysis, information entropy analysis, execution time analysis, and differential attack analysis in end‐to‐end encryption. The results indicate a significant improvement in encryption and decryption efficiency, showcasing the scheme's potential as a viable solution against the vulnerabilities posed by quantum computing advancements. Our research offers a novel perspective on a critical aspect of cybersecurity applications across healthcare, defence, finance, and beyond in the realm of secure quantum communication.
With the growing demand for highly secure medical data transmission, this research introduces a fused cryptography framework that integrates mathematical quantum computing operations with advanced classical encryption techniques. The proposed method incorporates quantum principles, including quantum walks, quantum-based cyclic shift operators, quantum XOR operations, and quantum key image generation with classical methods such as bit-plane extraction and hyperchaotic system-based scrambling. A hyperchaotic map generates random key sequences to produce both a spatial domain random image and a quantum key image. The medical image is first decomposed into eight bit-planes, and only the high-information bit-planes (HIBPs) undergo encryption to optimize computational efficiency. HIBPs are scrambled using multilayer, block-wise, and diagonal permutations based on the chaotic sequences. Quantum encryption is then applied, starting with novel enhanced quantum representation encoding, followed by Baker map-based scrambling and quantum XOR diffusion to secure the final ciphertext. Extensive experiments, including entropy evaluation, noise attack resilience, clipping attack robustness, and correlation analysis, confirm the superior security and performance of the proposed method. Notably, the algorithm achieves near-ideal results, such as an entropy of 7.9999, a correlation coefficient of 0.0001, 98% plaintext recovery after 30% noise corruption, and 96% recovery after 25% ciphertext clipping, demonstrating its robustness for secure medical data transmission.
Quantum computing introduces major threats to conventional image encryption methods, especially in medical contexts. This paper addresses these threats by developing a quantum-resistant encryption scheme for medical images. We present a novel framework combining: (1) a novel Mixed Logistic-Ikeda-Henon (MLIH) chaotic map for pseudorandom key generation, (2) quantum image representation using the Novel Enhanced Quantum Representation (NEQR) model, and (3) a two-stage encryption process employing Controlled-Not (CNOT) gate chaining for diffusion and One-Time Pad (OTP) with MLIH-generated keys for confusion. The RGB channels are processed separately through quantum state conversion, CNOT-based diffusion, and keyed confusion before final recombination. To validate practical feasibility, the proposed encryption scheme was implemented on IBM’s 127-qubit ibm_sherbrooke quantum processor, demonstrating real-world feasibility. Experimental validation shows near-ideal entropy (7.9977), superior NPCR (99.97%) and UACI (33.89%) values, and an expansive key space (2 1952 ). The novel MLIH demonstrates a 12.7% improvement in logic gate efficiency compared to conventional chaotic and the image encryption has quantum advantage through parallel CNOT operations. The hardware execution yielded a throughput of 4,500 Circuit Layer Operations Per Second (CLOPS), indicating efficient real-time performance on NISQ devices, Moreover, the echoed cross-resonance (ECR) gate error remained within a median of 1.1 × 10⁻ 2 , supporting reliable circuit execution. The proposed scheme outperforms contemporary quantum and classical encryption approaches in terms of entropy, NPCR, UACI, and key sensitivity, all while maintaining a computational complexity of O(n), ensuring scalability. This study effectively bridges the gap between theoretical quantum security models and real-world implementation on existing NISQ devices, demonstrating resilience against classical statistical and differential attacks, as well as quantum-specific threats such as Grover’s brute-force search and quantum chosen-plaintext attacks. The successful deployment of IBM quantum hardware positions this scheme as a viable solution for secure medical image transmission in quantum-era healthcare systems.
Secure image transmission is increasingly vital in the digital era, especially against emerging quantum threats. This study proposes a hybrid image encryption scheme that integrates Quantum Key Distribution (QKD) using the BB84 protocol with a combination of 7-dimensional (7D) and 2-dimensional (2D) hyperchaotic systems to achieve robust security. The BB84 protocol facilitates quantum-assisted key exchange, ensuring resistance to eavesdropping, while the hyperchaotic systems provide high entropy and complex randomness, utilized in a layered permutation-substitution encryption framework. The initial seeds for chaotic sequences are derived using a SHA-512 hash of both the input image and quantum-generated key, ensuring uniqueness and sensitivity. Experimental validation was conducted using several benchmark images. The information entropy values of the ciphered images reached up to 7.9993, indicating excellent randomness. Differential analysis showed high resistance to small perturbations, with NPCR exceeding 99.61% and UACI averaging around 33.47%, which meet standard security thresholds. Histogram and chi-square tests confirmed the uniform pixel distribution, with chi-square values below 280, satisfying the randomness criterion for 8-bit images. Furthermore, correlation coefficients of adjacent pixels dropped to near zero, evidencing effective decorrelation. The encryption scheme also demonstrated robustness to data loss, as shown by the successful decryption of partially corrupted cipher images. Robustness testing under partial data loss (200×200-pixel blocks) also demonstrated visual recoverability and algorithm resilience. Overall, the proposed BB84-assisted dual-hyperchaotic encryption scheme offers a secure and computationally effective solution for protecting sensitive image data, making it suitable for post-quantum secure communications.