HOUSTON – Scientists with the National Space Biomedical Research Institute (NSBRI) have developed tools that expand the use of ultrasound during spaceflight and on Earth, especially in rural and underserved locations.
The tools include techniques that streamline training and help remote experts guide non-physician astronauts to perform ultrasound exams. Ultrasound can be used to assess numerous conditions – fractured bones, collapsed lungs, kidney stones, organ damage and other ailments,
With an NSBRI grant, scientists also created a catalog, or atlas, of "space-normal" imagery of the human body, setting the stage for astronauts to provide care without consulting a physician on Earth.
The atlas was handed over to NASA earlier this year.
Scott A. Dulchavsky, the Roy D. McClure, MD, chairman of surgery and surgeon-in-chief at the Henry Ford Hospital in Detroit, is the principal investigator of these projects and is a member of the NSBRI Smart Medical Systems and Technology Team.
"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," he said. "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."
Dulchavsky and his colleagues from NSBRI, NASA, Henry Ford and Wyle Integrated Science and Engineering Group 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 ADUM research was split into two projects: NSBRI funded the ground portion of the research, while NASA supported the flight portion.
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 "space-normal" atlas.
The researchers developed the intuitive ultrasound guide to give astronauts broader use of ultrasound in additional organ systems and medical problems that were not part of the ISS experiment. 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."
One of the first to be trained and to conduct an ultrasound exam in space was former NASA Astronaut and ISS Expedition 10 Commander Leroy Chiao,
"We demonstrated on the International Space Station that even non-physicians can produce diagnostic-quality ultrasound images using remote guidance," said Chiao who is chairman of the NSBRI User Panel and a member of Baylor College of Medicine's Center for Space Medicine. "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."
As in space, low costs and reduced-resource consumption make ultrasound an attractive option on Earth, but until recently, the lack of trained personnel has been an issue. Based on their research for NSBRI, Dulchavsky and his colleagues have spun off the techniques for terrestrial use and published "The ICU Ultrasound Pocket Book" – a reference guide for conducting examinations.
The ultrasound imaging techniques are also being used by athletic trainers for some professional sports teams and the United States Olympic Committee to get point-of-care rapid information about athletes' injuries.
However, it is rural locations, both inside and outside the United States, that stand to gain the most from the diagnostic ultrasound capabilities and telemedicine. Dulchavsky has been collaborating with the World Interactive Network Focused on Critical UltraSound (WINFOCUS) to train individuals to use ultrasound techniques in under-served regions.
Healthcare IT News
http://www.healthcareitnews.com/news/space-research-yields-new-ultrasound-tools
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