Ultrasound techniques allow astronauts to become doctors

Researchers in the US have developed tools that expand the use of ultrasound during spaceflight and in remote locations on Earth.

The work from the National Space Biomedical Research Institute (NSBRI) in Texas includes techniques to help remote experts guide non-physician astronauts to perform ultrasound exams.

The team also created a catalogue of imagery of the human body, which was given to NASA earlier this year, to allow astronauts to assess fractured bones, collapsed lungs, kidney stones, organ damage and other problems without consulting a doctor

Dr Scott Dulchavsky, principal investigator and surgeon-in-chief at the Henry Ford Hospital in Detroit said: ‘The ultrasound imagery techniques came from space program constraints of not having a trained radiologist on orbit or having a CAT scan or an MRI available, forcing us to use ultrasound for things in which we would not normally use it.

‘Also, time limitations forced us to put some tight brackets around what is absolutely required for training to be able to obtain a high-quality ultrasound image and to make some sense out of the image.’

The team began their first ultrasound experiment – Advanced Diagnostic Ultrasound in Microgravity (ADUM) – by developing exam techniques for use on the International Space Station (ISS).

The goal was for ISS crewmembers to collect high-quality ultrasound images to send to the Mission Control Center for analysis.

The researchers conducted 80 hours of ultrasound examinations on the ISS and then sifted through approximately 20,000 images and many hours of video collected during ISS Expeditions 8 through 12 to create the catalogue.

Dulchavsky said: ‘ADUM initially utilized telemedicine and tele-ultrasound operations in which the astronauts were interacting with researchers and flight controllers on the ground during the examinations.

‘The ultrasound intuitive guide allows astronauts to conduct exams when quick communication with an expert is not available due to distance from Earth or other reasons.’

ISS Expedition 10 Commander Dr Leroy Chiao, one of the first to be trained to use the equipment, said: ‘We demonstrated on the International Space Station that even non-physicians can produce diagnostic-quality ultrasound images using remote guidance.

‘These ultrasound exam techniques and atlas will be increasingly important as we venture farther and longer into space. Telemedicine using ultrasound will be an invaluable medical diagnostic tool.’

The techniques could also benefit rural locations and Dulchavsky has been collaborating with the World Interactive Network Focused on Critical UltraSound (WINFOCUS) to train individuals to use ultrasound techniques in regions where trained doctors are rare.

Some of the countries in which the ultrasound techniques are being implemented to foster sustainable primary health-care development are Mozambique, Lesotho, Madagascar, India, Brazil and Nicaragua, with programmes planned in Honduras, Congo and Malaysia.

Tele-ultrasound has also been performed by Dulchavsky’s team on Mount Everest and in the high Arctic Circle.

The NSBRI Smart Medical Systems and Technology Team portfolio contains projects developing other innovative ultrasound technologies.

One project is developing an ultrasound system to measure bone density and quality and accelerate fracture healing. Another project is developing a system for bloodless tumour removal, internal bleeding treatment and kidney stone reduction.