Dr. Scott Dulchavsky, surgeon-in-chief at the Henry Ford Hospital in Detroit, was the principal investigator on projects to develop tools to expand the use of ultrasound technology on Earth -- and in space. A member of the National Space Biomedical Research Institute Smart Medical Systems and Technology Team, Dulchavsky spoke with me yesterday about his work.
"How can I provide the medical care we've developed in a fancy trauma center... to be appropriate on the shuttle, the space station or exploration missions to a different planet?" Dulchavsky said. "There are some challenges."
Challenge 1: There's not a lot of medical equipment in space. The International Space Station has no CAT scan, MRI or X-ray capabilities, Dulchavsky said. It does have ultrasound equipment, but many medical conditions, such as brain swelling and broken bones, are diagnosed on Earth using other tests.
To stretch the technology for possible use in space, the team at Dulchavsky's hospital used ultrasound technology to diagnose a variety of injured or ill patients -- even if ultrasound wasn't the traditional test for that condition. The ultrasound tests weren't just accurate, Dulchavsky said. They sometimes exceeded the capabilities of other tests. "At least in expert hands," Dulchavsky said, "it's a pretty interesting tool."
Challenge 2: Astronauts get some medical training, but they're hardly health experts. "How do I get an engineer or a geophysicist to do what has taken me years to do?" Dulchavsky said. "My task with NASA and the NSBRI was to develop methodologies, training tools and the ability to utilize an ultrasound machine to provide high-end diagnostic potentials where they didn't have them."
Dulchavsky's team developed multimedia interpretations that helped non-expert ultrasound operators produce suitable images. "We did over 100 hours of those examinations on the International Space Station," Dulchavsky said. The team also developed tela-ultrasound capabilities that would allow Dulchavsky to watch an ultrasound conducted in space from Mission Control.
Why do we need ultrasound technology in space, anyway? At first, NASA wanted to use ultrasound to monitor changes to astronaut health during extended periods of weightlessness, Dulchavsky said. But the equipment is also used to monitor occasional injuries or health concerns astronauts face in space, he added.
Using the principles they pioneered with ultrasound in space, Dulchavsky and his team are also working with the United Nations to bring the technology to remote regions in developing nations. The team is training non-physicians to use portable ultrasound devices to provide patients with information on childhood pneumonia, infectious diseases and other ailments. While people living in parts of Africa and Asia might not have access to a physician -- much less an MRI machine or CT scanner -- the portable ultrasound could serve as a stand-in. "We'll hook those machines up via the Internet to their regional hospitals," Dulchavsky said. "We'll provide follow up training to allow them to increase their skill levels."
For Dulchavsky, the next step in space is to help astronauts go from producing ultrasound images to knowing what to do with them. "They aren't, as non-physicians, able to take the images that they acquire and interpret them to try to develop a care plan," he said. Back on Earth, Dulchavsky's upcoming work involves producing ultrasound training for medical schools.
Photo: Dr. Scott Dulchavsky