<![CDATA[The transmission of medical images over telemedicine networks increases the risk of data leakage and manipulation of sensitive information. This study develops a Reversible Data Hiding framework that integrates Spatial Fuzzy C-Means, Selective Histogram Shifting, and a measurable Distortion Control Mechanism for securing T1-weighted brain MRI images. The proposed method prioritizes the preservation of Region of Interest intensity characteristics and full reversibility over embedding capacity. SFCM is employed to generate Region of Interest and Non-Region of Interest mappings based on intensity distribution, with adaptive parameter adjustment for each slice. Data embedding is performed selectively on NROI using histogram shifting, while ROI areas remain unmodified. An Adaptive Feedback Control mechanism monitors image quality metrics SNR, CNR, GLCM with conservative thresholds (ΔSNR ≤ 2.0%, ΔCNR ≤ 1.0%) to ensure ROI stability. Experimental evaluation on the OASIS-1 dataset shows that the proposed method achieves an average PSNR of 54.13 dB, SSIM of 0.9996, and NCC of 0.9999, with an embedding capacity of 630 bits per slice (BPP 0.007-0.013 within NROI). Reversibility verification confirms perfect recovery (maximum difference = 0) for all samples. Batch testing on five slices demonstrates consistent performance across varying intensity characteristics, with ΔSNR and ΔCNR remaining at 0.0%. These results indicate that the method is capable of maintaining ROI technical integrity and pixel-perfect reversibility, although with a limited capacity suitable for lightweight metadata such as integrity hashes and patient identifiers. Limitations of the study include the technical-only evaluation without radiologist clinical validation and testing restricted to T1-weighted MRI modality.]]>
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