Ultrasound studies demonstrate potential for telemedicine in space

HDI 5000 plays key role on orbiting space station

Astronauts onboard the International Space Station fired up an ultrasound scanner last fall to demonstrate the feasibility of remotely guided medical care. Shannon Melton from the space medicine division of NASA contractor Wyle Laboratories in Houston reported on the development of a remote guidance system June 2 at the 10th Congress of the World Federation for Ultrasound in Medicine and Biology in Montreal. The data were obtained using an HDI 5000 modified by Philips Medical Systems for launch into space in March 2001 (SCAN 3/28/01).

NASA is using the HDI 5000 to develop the means by which physicians on the ground can instruct astronauts to handle medical emergencies. Rather than putting a trained physician onboard the space station or, eventually, spacecraft headed to other planets, NASA would like to give astronauts the wherewithal to send physicians on the ground enough information to diagnose problems and, ideally, handle them without executing an emergency return to earth.

In the development of their medical guidance system, Melton and others in her group leveraged a real-time video downlink and bidirectional voice communications to instruct astronauts in the capture of clinically useful imaging data for evaluation on the ground. Standardized protocols developed on earth were modified for microgravity. These included an expanded FAST (focused assessment by sonography in trauma) examination with hemo- and pneumothorax screening, general abdominal survey, and duplex carotid examination, according to Melton.

The ultrasound images beamed to earth Sept. 13, 2002, showed the lung moving underneath the chest wall lining. The technique could be used to detect a collapsed lung in the case of a real medical emergency, such as chest trauma.

"Technological advances in ultrasound are providing researchers more latitude to choose very specific areas of in-orbit research," she said.

Melton, ultrasound specialist Dr. Ashot Sargasyan, and crew surgeon Dr. Jeff Jones monitored the ultrasound images for more than four hours, guiding flight engineer Peggy Whitson in the examination of several organ systems. Whitson visualized a beating heart, with chambers and valves opening and closing, and generated Doppler images indicating blood-flow characteristics inside the heart.