Federated learning (FL) allows a set of clients to collaboratively train a machine-learning model without exposing local training samples. In this context, it is considered to be privacy-preserving and hence has been adopted by medical centers to train machine-learning models over private data. However, in this paper, we propose a novel attack named MediLeak that enables a malicious parameter server to recover high-fidelity patient images from the model updates uploaded by the clients. MediLeak requires the server to generate an adversarial model by adding a crafted module in front of the original model architecture. It is published to the clients in the regular FL training process and each client conducts local training on it to generate corresponding model updates. Then, based on the FL protocol, the model updates are sent back to the server and our proposed analytical method recovers private data from the parameter updates of the crafted module. We provide a comprehensive analysis for MediLeak and show that it can successfully break the state-of-the-art cryptographic secure aggregation protocols, designed to protect the FL systems from privacy inference attacks. We implement MediLeak on the MedMNIST and COVIDx CXR-4 datasets. The results show that MediLeak can nearly perfectly recover private images with high recovery rates and quantitative scores. We further perform downstream tasks such as disease classification with the recovered data, where our results show no significant performance degradation compared to using the original training samples.

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