Cybersecurity is the protection of digital data, software and hardware from risks including attacks or other problems related to their integrity and/or data confidentiality. Cybersecurity may utilize many different types of tools and protocols including encryption, firewalls and other infrastructure to manage access to data and computer systems. Training protocols, guidelines, regulations, legal policies and ultimately human behaviors are also important tools for safeguarding data.
DICOM file formats have proven intrinsic vulnerabilities 1. Due to the increasing use of mobile devices 2and teleradiology, radiology has incorporated increasing cybersecurity risks. As different AI models are incorporated into radiology research and practice, many issues including distributed systems and models also present potential problems. Notably GANs have been shown to make images that radiologists could not detect as synthetic 3. Clinical photographs also present cybersecurity issues for radiologists 4.
In spite of increasing awareness 5, regulations and academic literature on digital security in radiology, many medical images are (as of 2019) exposed, i.e. accessible including patient identifying data due to lack of very basic cybersecurity protections e.g. not connecting PACS directly to the internet.
- 1. Benoit Desjardins, Yisroel Mirsky, Markel Picado Ortiz, Zeev Glozman, Lawrence Tarbox, Robert Horn, Steven C. Horii. DICOM Images Have Been Hacked! Now What?. (2019) American Journal of Roentgenology. doi:10.2214/AJR.19.21958 - Pubmed
- 2. Perry Gerard, Neil Kapadia, Jay Acharya, Patricia T. Chang, Zvi Lefkovitz. Cybersecurity in Radiology: Access of Public Hot Spots and Public Wi-Fi and Prevention of Cybercrimes and HIPAA Violations. (2013) American Journal of Roentgenology. 201 (6): 1186-9. doi:10.2214/AJR.12.9651 - Pubmed
- 3. Becker AS, Jendele L, Skopek O, Berger N, Ghafoor S, Marcon M, Konukoglu E. Injecting and removing suspicious features in breast imaging with CycleGAN: A pilot study of automated adversarial attacks using neural networks on small images. (2019) European journal of radiology. 120: 108649. doi:10.1016/j.ejrad.2019.108649 - Pubmed
- 4. Srini Tridandapani, Pamela Bhatti, Carson Wick. Patient Photographs: Privacy Versus Protection. (2018) American Journal of Roentgenology. 212 (2): 320-322. doi:10.2214/AJR.18.20452 - Pubmed
- 5. Mark Stites, Oleg S. Pianykh. How Secure Is Your Radiology Department? Mapping Digital Radiology Adoption and Security Worldwide. (2016) American Journal of Roentgenology. 206 (4): 797-804. doi:10.2214/AJR.15.15283 - Pubmed