A scientific manuscript submitted by International Space Station (ISS) astronauts while in space was published today. The research findings show minimally trained operators using remote guidance can perform ultrasound in space.
The results of the shoulder ultrasound exams done in space for the first time will advance the care of space travelers on long-duration missions and may find additional uses helping treat medical emergencies on Earth.
The article is available today in the on-line version of Radiology and will appear in print in the February 2005 issue.
"Remotely guided ultrasound is a significant and clinically relevant advancement in space medicine, providing a reliable and versatile diagnostic tool for health care in long-duration missions, particularly as we progress to exploration-class missions in the future," said Nitza Cintron, M.D., Ph.D., head of Space Medicine at NASA's Johnson Space Center (JSC) in Houston.
Shoulder evaluation using ultrasound is the standard of care at many institutions and is used by professional teams to evaluate injuries to athletes. Astronauts may be at risk of shoulder injury due to exertion during spacewalks, combined with decreases in muscle and tendon mass during long-duration spaceflight.
Working in the Space Station's Human Research Facility, Expedition 9 Commander Gennady Padalka and NASA ISS Science Officer Mike Fincke, co-authors of the article, tested the ability of nonphysician crewmembers to perform ultrasonography of the shoulder. They did the diagnostic tests monthly during their six-month stay aboard the Station, last April to October, as part of the Advanced Diagnostic Ultrasound in Microgravity project.
Ultrasound images of the shoulder were transmitted as they were made on the Station to experts in the Telescience Center at JSC. The experts on the ground guided Padalka and Fincke through the positioning, probe placement, and manipulation and equipment adjustments to get optimal images. The crew used novel positioning techniques for the subject and operator to facilitate the examination in the microgravity environment.
Still images were captured during the exams and downlinked to the experimental team. These high-fidelity images could be used to exclude subtle changes in shoulder integrity. There were no clear differences between the tests done in space and those done in standard conditions on Earth.
"The Advanced Diagnostic Ultrasound in Microgravity project has just begun to provide a great and useful capability on board the Space Station with direct implications to improve life on Earth in the fields of emergency, rural and remote medicine," Fincke said. "The remotely guided ultrasound concept, with trained first-responders as operators, is a significant and clinically relevant advancement in space science, with profound ramifications for emergency or clinical care."
Researchers from NASA, Henry Ford Hospital in Detroit, Wyle Laboratories in Houston and Texas Diagnostic Imaging in Dallas participated in the tests and contributed to the article.
"Mike Fincke and Gennady Padalka have proven that nonphysicians can perform complex medical tasks using just-in-time training and remote expert guidance," said Scott Dulchavsky, M.D., Ph.D., chair of the Department of Surgery at Henry Ford Hospital in Detroit, principal investigator for the Space Station ultrasound experiment and co-author of the article. "This is a significant advance for providing medical care in space; however, these techniques are directly transferable to Earth to improve patient care in remote locations including underserved areas, rural communities, and during military conflicts," he added.
To view the article on the Internet, visit:
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