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:
http://radiology.rsnajnls.org/cgi/content/full/2342041680v1