Diagnostic Medical Imaging Program- Information Packet and ...
Diagnostic Imaging in the Medical Support Of the Future ... · Diagnostic Imaging in the Medical...
35
Diagnostic Imaging in the Medical Diagnostic Imaging in the Medical Support Support Of the Future Missions to the Of the Future Missions to the Moon Moon AsMA AsMA - - 2007 2007 New Orleans, Louisiana, USA New Orleans, Louisiana, USA Ashot E. Sargsyan MD; Jeffrey A. Jones, MD, Douglas R Hamilton, MD, PhD‡; Scott A. Dulchavsky MD, PhD†, J. Michael Duncan, MD https://ntrs.nasa.gov/search.jsp?R=20070022323 2018-06-21T00:32:58+00:00Z
Transcript of Diagnostic Imaging in the Medical Support Of the Future ... · Diagnostic Imaging in the Medical...
Dia
gnos
tic Im
agin
g in
the
Med
ical
D
iagn
ostic
Imag
ing
in th
e M
edic
al
Supp
ort
Supp
ort
Of t
he F
utur
e M
issi
ons
to th
e O
f the
Fut
ure
Mis
sion
s to
the
Moo
n M
oon
AsM
A As
MA
-- 200
720
07N
ew O
rlean
s, L
ouis
iana
, US
AN
ew O
rlean
s, L
ouis
iana
, US
A
Ash
ot E
. Sar
gsya
n M
D; J
effre
y A
. Jon
es, M
D, D
ougl
as R
H
amilt
on, M
D, P
hD‡;
Sco
tt A
. Dul
chav
sky
MD
, PhD
†,
J. M
icha
el D
unca
n, M
D
https://ntrs.nasa.gov/search.jsp?R=20070022323 2018-06-21T00:32:58+00:00Z
Educ
atio
nal O
bjec
tives
Educ
atio
nal O
bjec
tives
1) U
pdat
e th
e au
dien
ce o
n th
e cu
rren
t exp
erie
nce
in
1) U
pdat
e th
e au
dien
ce o
n th
e cu
rren
t exp
erie
nce
in
ultr
asou
nd im
agin
g in
spa
ce fl
ight
ultr
asou
nd im
agin
g in
spa
ce fl
ight
2) D
iscu
ss th
e un
ique
asp
ects
of c
ondu
ctin
g 2)
Dis
cuss
the
uniq
ue a
spec
ts o
f con
duct
ing
ultr
asou
nd im
agin
g on
ISS,
inte
rpla
neta
ry tr
ansi
t, ul
tras
ound
imag
ing
on IS
S, in
terp
lane
tary
tran
sit,
and
luna
r sur
face
ope
ratio
nsan
d lu
nar s
urfa
ce o
pera
tions
3) R
evie
w p
relim
inar
y da
ta o
btai
ned
in s
imul
atio
ns o
f 3)
Rev
iew
pre
limin
ary
data
obt
aine
d in
sim
ulat
ions
of
med
ical
imag
ing
in lu
nar s
urfa
ce o
pera
tions
med
ical
imag
ing
in lu
nar s
urfa
ce o
pera
tions
Pre
Pre --
lect
ure
test
lect
ure
test
Wha
t im
agin
g ex
perie
nce
on IS
S d
o w
e ha
ve?
Wha
t im
agin
g ex
perie
nce
on IS
S d
o w
e ha
ve?
Whi
ch c
linic
al im
agin
g ap
plic
atio
ns a
re c
urre
ntly
W
hich
clin
ical
imag
ing
appl
icat
ions
are
cur
rent
ly
avai
labl
e to
the
ISS
Sur
geon
on
cons
ole?
avai
labl
e to
the
ISS
Sur
geon
on
cons
ole?
Are
ther
e an
y ob
viou
s di
ffere
nces
am
ong
0G,
Are
ther
e an
y ob
viou
s di
ffere
nces
am
ong
0G,
1/6G
, and
1G
imag
ing
anat
omy?
1/6G
, and
1G
imag
ing
anat
omy?
How
doe
s th
e IS
S e
xper
ienc
e re
late
to
How
doe
s th
e IS
S e
xper
ienc
e re
late
to
Exp
lora
tion?
Exp
lora
tion?
Wha
t are
the
desi
gn o
ptio
ns fo
r put
ting
and
Wha
t are
the
desi
gn o
ptio
ns fo
r put
ting
and
oper
atin
g an
ultr
asou
nd s
yste
m in
a s
pace
craf
t op
erat
ing
an u
ltras
ound
sys
tem
in a
spa
cecr
aft
or h
abita
t on
the
luna
r sur
face
?or
hab
itat o
n th
e lu
nar s
urfa
ce?
LEO
Ultr
asou
nd
LEO
Ultr
asou
nd
Of t
he m
any
imag
ing
mod
aliti
es, u
ltras
ound
ha
s be
en th
e on
ly o
ne
foun
d su
itabl
e fo
r use
in
low
-Ear
th o
rbit.
ISS
Ultr
asou
nd O
pera
tions
ISS
Ultr
asou
nd O
pera
tions
Hou
rs o
f Ope
ratio
n
Med
Ops
/ H
RF
20
Tota
l10
510
5
Res
earc
h8585
ISS
Ultr
asou
nd O
verv
iew
ISS
Ultr
asou
nd O
verv
iew
Ultr
asou
nd im
agin
g ha
s be
en p
lace
d am
ong
the
Ultr
asou
nd im
agin
g ha
s be
en p
lace
d am
ong
the
ISS
oper
atio
nal m
edic
al re
quire
men
ts;
ISS
oper
atio
nal m
edic
al re
quire
men
ts;
Mos
t clin
ical
app
licat
ions
are
con
side
red
feas
ible
, M
ost c
linic
al a
pplic
atio
ns a
re c
onsi
dere
d fe
asib
le,
alth
ough
al
thou
gh e
vide
nce
evid
ence
is p
artia
l or i
ndire
ct:
is p
artia
l or i
ndire
ct:
ISS
evid
ence
with
hea
lthy
subj
ects
ISS
evid
ence
with
hea
lthy
subj
ects
KCKC-- 1
35 (o
r C13
5 (o
r C-- 9
) dat
a w
ith h
ealth
y su
bjec
ts9)
dat
a w
ith h
ealth
y su
bjec
tsKCKC
-- 135
(or C
135
(or C
-- 9) d
ata
on a
nim
al m
odel
s of
9)
dat
a on
ani
mal
mod
els
of
dise
ase
and
traum
adi
seas
e an
d tra
uma
Qua
lity
and
com
plet
enes
s of
ISS
Qua
lity
and
com
plet
enes
s of
ISS
ultra
soun
d da
ta h
ave
bee
n ju
dged
ul
traso
und
data
hav
e b
een
judg
ed
acce
ptab
le fo
r dia
gnos
tic p
urpo
ses
acce
ptab
le fo
r dia
gnos
tic p
urpo
ses
Prin
cipl
es o
f Rem
ote
Ultr
asou
ndPr
inci
ples
of R
emot
e U
ltras
ound
Dis
tribu
ted
Exp
ertis
eD
istri
bute
d E
xper
tise
betw
een
crew
, gro
und
expe
rts, a
nd d
igita
l be
twee
n cr
ew, g
roun
d ex
perts
, and
dig
ital
reso
urce
s re
sour
ces
Com
mon
Kno
wle
dge
Bas
eC
omm
on K
now
ledg
e B
ase
pre
pre --
mis
sion
trai
ning
mat
eria
lm
issi
on tr
aini
ng m
ater
ial
just
just
-- inin-- ti
me
train
ing
mat
eria
ltim
e tra
inin
g m
ater
ial
gene
ral p
roce
dure
sge
nera
l pro
cedu
res
appl
icat
ion
appl
icat
ion --
spec
ific
focu
sed
prot
ocol
ssp
ecifi
c fo
cuse
d pr
otoc
ols
targ
et v
iew
s an
d im
ages
ta
rget
vie
ws
and
imag
es
term
inol
ogy
term
inol
ogy
dem
onst
ratio
ns p
hoto
and
de
mon
stra
tions
pho
to a
nd v
ideo
,tips
vide
o,tip
san
d hi
nts
and
hint
s
Prin
cipl
es o
f Rem
ote
Ultr
asou
ndPr
inci
ples
of R
emot
e U
ltras
ound
Cle
ar Id
entif
icat
ion
of R
espo
nsib
ility
Cle
ar Id
entif
icat
ion
of R
espo
nsib
ility
betw
een
crew
and
gro
und
expe
rtsbe
twee
n cr
ew a
nd g
roun
d ex
perts
Clin
ical
and
Ope
ratio
nal S
ubor
dina
tion
Clin
ical
and
Ope
ratio
nal S
ubor
dina
tion
stud
ies
are
orde
red
by th
e C
rew
st
udie
s ar
e or
dere
d by
the
Cre
w
Surg
eon
whe
n cl
inic
ally
indi
cate
d an
d Su
rgeo
n w
hen
clin
ical
ly in
dica
ted
and
oper
atio
nally
pra
ctic
alop
erat
iona
lly p
ract
ical
imag
ing
expe
rts a
re s
ubor
dina
ted
to
imag
ing
expe
rts a
re s
ubor
dina
ted
to
the
ISS
Cre
w S
urge
on
the
ISS
Cre
w S
urge
on
Prin
cipl
es o
f Rem
ote
Ultr
asou
ndPr
inci
ples
of R
emot
e U
ltras
ound
Focu
sed
Exa
min
atio
nFo
cuse
d E
xam
inat
ion
Imag
ing
follo
ws
a pr
eIm
agin
g fo
llow
s a
pre --
defin
ed a
nd s
trict
ly
defin
ed a
nd s
trict
ly
prio
ritiz
ed s
eque
nce
of c
linic
al
prio
ritiz
ed s
eque
nce
of c
linic
al
ques
tions
qu
estio
ns
Info
rmat
ion
obta
ined
can
be
just
one
In
form
atio
n ob
tain
ed c
an b
e ju
st o
ne
criti
cal i
mag
e or
a fu
llcr
itica
l im
age
or a
full --
fledg
ed s
et o
f fle
dged
set
of
fram
es a
nd v
ideo
loop
sfra
mes
and
vid
eo lo
ops
Illus
tratio
n on
the
next
slid
eIll
ustra
tion
on th
e ne
xt s
lide
Thor
ough
eva
luat
ion
of
Ipsi
late
rala
nd
Con
tral
ater
alK
idn
eys
Exam
ple:
Ren
al O
bstr
uctio
nEx
ampl
e: R
enal
Obs
truc
tion
Com
plet
e pr
otoc
olC
ompl
ete
prot
ocol
Oth
er s
tone
s?O
ther
sto
nes?
Nat
ure
of O
bstru
ctio
nN
atur
e of
Obs
truct
ion
Leve
l of O
bstru
ctio
nLe
vel o
f Obs
truct
ion
Deg
ree
of O
bstru
ctio
n D
egre
e of
Obs
truct
ion
and
seco
ndar
y S
igns
and
seco
ndar
y S
igns
Pre
senc
e of
P
rese
nce
of
Obs
truct
ion
Obs
truct
ion
Focu
sed
eval
uat
ion
of
ure
ter
An
d bl
adde
r
Mu
ltip
le V
iew
s of
Ren
alP
elvi
s, U
rete
r
Ure
tera
l Jet
s
Kid
ney
Stru
ctur
e
ISS
Ultr
asou
nd E
stim
ated
Tim
elin
e IS
S U
ltras
ound
Est
imat
ed T
imel
ine
-- 11
ISS
Ultr
asou
nd E
stim
ated
Tim
elin
e IS
S U
ltras
ound
Est
imat
ed T
imel
ine
-- 22
ISS
Ultr
asou
nd E
stim
ated
Tim
elin
e IS
S U
ltras
ound
Est
imat
ed T
imel
ine
-- 33
ISS
Ultr
asou
nd E
stim
ated
Tim
elin
e IS
S U
ltras
ound
Est
imat
ed T
imel
ine
-- 44
Rea
lR
eal -- t
ime
Rem
ote
Gui
danc
e (M
inim
al
time
Rem
ote
Gui
danc
e (M
inim
al
Cre
w A
uton
omy)
Cre
w A
uton
omy)
Alte
rnat
ive
for
Med
ical
Ope
ratio
ns:
Alte
rnat
ive
for
Med
ical
Ope
ratio
ns:
Tele
scie
nce
Tele
scie
nce
Cent
er (
JSC
Bldg
. 30)
Cent
er (
JSC
Bldg
. 30)
Prim
ary
for
Med
ical
Ope
ratio
ns:
Prim
ary
for
Med
ical
Ope
ratio
ns:
Biom
edBi
omed
MPS
R (
JSC
Bldg
. 30S
)M
PSR (
JSC
Bldg
. 30S
)
Com
pute
rC
ompu
ter --
Ass
iste
d Fr
eeha
nd U
ltras
ound
A
ssis
ted
Free
hand
Ultr
asou
nd
Imag
ing
(Max
imal
Cre
w A
uton
omy)
Imag
ing
(Max
imal
Cre
w A
uton
omy)
•• Pro
toco
lPr
otoc
ol-- S
peci
fic J
ust
Spec
ific
Just
-- inin-- t
ime
Trai
ning
time
Trai
ning
•• Loa
ding
Pro
toco
lLo
adin
g Pr
otoc
ol-- S
peci
fic T
arge
t Vi
ews
and
Imag
esSp
ecifi
c Ta
rget
Vie
ws
and
Imag
es•• L
oadi
ng P
roto
col
Load
ing
Prot
ocol
-- spe
cific
Com
pute
r As
sist
ance
sp
ecifi
c Co
mpu
ter
Assi
stan
ce
Mod
ules
Mod
ules
•• Dat
a ac
quis
ition
with
out
grou
nd c
ontr
olD
ata
acqu
isiti
on w
ithou
t gr
ound
con
trol
•• Tra
nspa
rent
Dat
a do
wnl
ink
Tran
spar
ent
Dat
a do
wnl
ink
•• Gro
und
inte
rven
tion
if ne
cess
ary
and
pos
sibl
eG
roun
d in
terv
entio
n if
nece
ssar
y a
nd p
ossi
ble
Ultr
asou
nd H
ardw
are
Ultr
asou
nd H
ardw
are
-- ISSIS
S
Mod
ified
Phi
lips/
ATL
M
odifi
ed P
hilip
s/A
TL
5000
5000
Par
t of H
uman
Res
earc
h P
art o
f Hum
an R
esea
rch
Faci
lity
Faci
lity
Arr
ived
Mar
ch 2
001
Arr
ived
Mar
ch 2
001
Har
dwar
e Te
sted
on
10
Har
dwar
e Te
sted
on
10
Exp
editi
ons
2 E
xped
ition
s 2
-- 1111
Ultr
asou
nd s
essi
ons
Ultr
asou
nd s
essi
ons
cond
ucte
d on
sev
en IS
S
cond
ucte
d on
sev
en IS
S
Exp
editi
ons:
5
Exp
editi
ons:
5 --
1111
ISS
ultr
asou
nd is
the
first
hig
hIS
S ul
tras
ound
is th
e fir
st h
igh --
defin
ition
de
finiti
on
perm
anen
t im
agin
g ca
pabi
lity
in s
pace
perm
anen
t im
agin
g ca
pabi
lity
in s
pace
It m
ay a
lso
be o
ur la
st o
ppor
tuni
ty to
ans
wer
man
yqu
estio
ns in
spa
ce m
edic
ine
and
spac
e ph
ysio
logy
Luna
r Ultr
asou
nd S
yste
mLu
nar U
ltras
ound
Sys
tem
Imag
ing
har
dwar
eIm
agin
g h
ardw
are
Hig
hly
Por
tabl
e H
ighl
y P
orta
ble
Ultr
asou
nd
Ultr
asou
nd
Com
pute
r con
trol
Com
pute
r con
trol
Com
pute
r gui
danc
eC
ompu
ter g
uida
nce
Acc
esso
ries
Acc
esso
ries
Gel
, Wip
esG
el, W
ipes
Ele
ctro
des
Ele
ctro
des
Spa
ce
Spa
ce C
omm
Com
mA
sset
sA
sset
sV
ideo
dow
nlin
k w
ith
Vid
eo d
ownl
ink
with
va
riabl
e co
mpr
essi
onva
riabl
e co
mpr
essi
onS
tand
ard
dupl
ex v
oice
Sta
ndar
d du
plex
voi
ce
Gro
und
Sup
port
Gro
und
Sup
port
Ass
ets
Ass
ets
Voi
ce c
onso
les
Voi
ce c
onso
les
Vid
eo M
onito
rsV
ideo
Mon
itors
Sta
tus
mon
itorin
g fro
m
Sta
tus
mon
itorin
g fro
m
onsi
te c
ompu
ter
onsi
te c
ompu
ter
prog
ram
spr
ogra
ms
Rec
ordi
ng c
apab
ilitie
sR
ecor
ding
cap
abili
ties
Ultr
asou
nd H
ardw
are
Ultr
asou
nd H
ardw
are
-- Lun
arLu
nar
•• Sm
all,
light
wei
ght,
pos
sibl
y w
ith c
ontr
ol f
rom
a
Smal
l, lig
htw
eigh
t, p
ossi
bly
with
con
trol
fro
m a
ge
nera
l pur
pose
com
pute
rge
nera
l pur
pose
com
pute
r•• F
eedi
ng d
igita
l str
eam
to
an o
nboa
rd v
ideo
Fe
edin
g di
gita
l str
eam
to
an o
nboa
rd v
ideo
pr
oces
sing
uni
tpr
oces
sing
uni
t•• L
owLow
-- pow
er, m
aint
enan
cepo
wer
, mai
nten
ance
-- fre
e, a
nd u
nobt
rusi
vefr
ee, a
nd u
nobt
rusi
ve
•• Sof
twar
e on
the
onb
oard
gen
eral
pur
pose
So
ftw
are
on t
he o
nboa
rd g
ener
al p
urpo
se
com
pute
r:co
mpu
ter:
•• Jus
tJu
st-- I
nIn-- T
ime
trai
ning
Tim
e tr
aini
ng•• R
eal
Rea
l --tim
e vi
deo
anal
ysis
for
com
pute
rtim
e vi
deo
anal
ysis
for
com
pute
r --as
sist
ed
assi
sted
op
erat
or g
uida
nce
oper
ator
gui
danc
e•• D
ata
com
pres
sion
, sto
rage
, tra
nsm
issi
onD
ata
com
pres
sion
, sto
rage
, tra
nsm
issi
on•• R
elay
ing
inte
rven
tion
from
the
gro
und
Rela
ying
inte
rven
tion
from
the
gro
und
Payl
oad
Dev
elop
men
t Lab
orat
ory
Payl
oad
Dev
elop
men
t Lab
orat
ory
(PD
L, N
ASA
JSC
Bld
g. 9
)(P
DL,
NA
SA J
SC B
ldg.
9)
Ref
eren
ce
Ref
eren
ce
Targ
et Im
age
Targ
et Im
age
sets
sets
and
vide
os
and
vide
os
Proc
edur
e Pr
oced
ure
Vide
o cl
ips
Vide
o cl
ips
phot
osph
otos
K1K2
E1E1
E
E2E
E2
Just
Just
-- InIn-- T
ime
trai
ning
Ti
me
trai
ning
ISS
and
Luna
r Tec
hno
ISS
and
Luna
r Tec
hno --
chal
leng
esch
alle
nges
Har
dwar
e se
t up
Har
dwar
e se
t up ––
up to
45
min
(IS
S);
c.15
up
to 4
5 m
in (I
SS
); c.
15
min
(L)
min
(L)
Dat
a tra
nsm
issi
onD
ata
trans
mis
sion
-- 2s
dela
y (IS
S),
22s
del
ay (I
SS
), 2 --
7s (L
)7s
(L)
Sim
ulta
neou
s A
V li
nkS
imul
tane
ous
AV
link
-- sm
all b
lock
s (2
0sm
all b
lock
s (2
0 --50
50
m
in (I
SS
), co
ntin
uous
(L)
min
(IS
S),
cont
inuo
us (L
)V
ideo
Vid
eo No
Vid
eo C
ompr
essi
on (I
SS
), va
riabl
e (L
)N
o V
ideo
Com
pres
sion
(IS
S),
varia
ble
(L)
Som
e de
grad
atio
n of
vid
eoS
ome
degr
adat
ion
of v
ideo
Ultr
asou
nd P
roto
cols
Dem
onst
rate
d in
0g
Ultr
asou
nd P
roto
cols
Dem
onst
rate
d in
0g
Ech
ocar
diog
raph
yE
choc
ardi
ogra
phy
Stre
ss E
choc
ardi
ogra
phy
Stre
ss E
choc
ardi
ogra
phy
(lim
ited)
(lim
ited)
Thor
acic
: Th
orac
ic: H
emo
Hem
o --an
d an
d pn
eum
otho
rax
R/O
pneu
mot
hora
x R
/OAb
dom
inal
Abdo
min
alS
plee
n, L
iver
, Bili
ary
Sys
tem
, S
plee
n, L
iver
, Bili
ary
Sys
tem
, P
ancr
eas
Pan
crea
sA
A, I
VC
AA
, IV
CG
UG
UK
idne
ysK
idne
ysB
ladd
erB
ladd
erP
rost
ate
Pro
stat
eG
YN
GY
N
Mus
culo
skel
etal
Mus
culo
skel
etal
Rot
ator
Cuf
fR
otat
or C
uff
Kne
e, a
nkle
, elb
ow, w
rist,
Kne
e, a
nkle
, elb
ow, w
rist,
thor
acic
cag
eth
orac
ic c
age
Thyr
oid
Thyr
oid
Den
tal (
limite
d)D
enta
l (lim
ited)
Sin
us (l
imite
d)S
inus
(lim
ited)
Eye
Eye Vas
cula
ture
Vas
cula
ture
Car
otid
/Jug
ular
Car
otid
/Jug
ular
Val
salv
a/M
uelle
r Man
euve
rsV
alsa
lva/
Mue
ller M
aneu
vers
DV
T R
/OD
VT
R/O
Oth
er (e
.g.,
perip
hera
l ner
ves)
Oth
er (e
.g.,
perip
hera
l ner
ves)
Rev
iew
er C
omm
ents
Rev
iew
er C
omm
ents
““ I re
view
ed a
ll of
the
othe
r im
ages
you
sen
t.I r
evie
wed
all
of th
e ot
her i
mag
es y
ou s
ent.
As
As
you
stat
ed, t
hey
are
all m
ildly
blu
rry
due
to th
e yo
u st
ated
, the
y ar
e al
l mild
ly b
lurr
y du
e to
the
capt
ure
proc
ess
from
vid
eota
pe.
capt
ure
proc
ess
from
vid
eota
pe.
If I i
gnor
e th
is
If I i
gnor
e th
is
degr
adat
ion,
I be
lieve
that
all
of th
e im
ages
are
de
grad
atio
n, I
belie
ve th
at a
ll of
the
imag
es a
re
equa
l in
qual
ity to
thos
e w
e us
e ev
eryd
ay in
our
eq
ual i
n qu
ality
to th
ose
we
use
ever
yday
in o
ur
hosp
itals
.ho
spita
ls.
We
use
two
diffe
rent
type
s of
W
e us
e tw
o di
ffere
nt ty
pes
of
units
:un
its:
(1) P
hilip
s (1
) Phi
lips
HD
I 500
0H
DI 5
000
with
the
late
st
with
the
late
st
softw
are,
incl
udin
g X
RE
S im
age
proc
essi
ng a
nd
softw
are,
incl
udin
g X
RE
S im
age
proc
essi
ng a
nd
Son
oS
ono --
CT
real
CT
real
-- tim
e co
mpo
und
imag
ing,
and
(2)
time
com
poun
d im
agin
g, a
nd (2
) S
iem
ens
Sie
men
s A
cuso
nA
cuso
nS
equo
ia.
Seq
uoia
. The
imag
es y
ou
The
imag
es y
ou
sent
are
equ
al in
qua
lity
to w
hat I
see
dai
ly
sent
are
equ
al in
qua
lity
to w
hat I
see
dai
ly
on th
e ab
ove
units
.”
on th
e ab
ove
units
.”
Rev
iew
er C
omm
ents
Rev
iew
er C
omm
ents
““ The
imag
es y
ou s
ent w
ere
all n
orm
al
The
imag
es y
ou s
ent w
ere
all n
orm
al
and
I exp
ect t
hat y
ou w
ill h
ave
no
and
I exp
ect t
hat y
ou w
ill h
ave
no
trou
ble
diag
nosi
ng d
isea
se w
hen
it tr
oubl
e di
agno
sing
dis
ease
whe
n it
aris
es.
aris
es. ””
Sam
ple
App
licat
ion
List
for O
rder
ing
Sam
ple
App
licat
ion
List
for O
rder
ing
HE
AD
NE
CK
AN
D F
AC
E
APPL
ICAT
ION
TITL
ETY
PENO
TES
/ SCO
PEDo
ne w
ith
rem
ote
guid
nce
?
Perfo
rmed
on
ISS?
Ophth
almic
Sono
grap
hy C
omple
te Co
mplet
e (St
anda
rd)
YY
Saliv
ary G
land S
onog
raph
y Com
plete
Comp
lete (
Stan
dard
)Y
NTh
yroid
Sono
grap
hy C
omple
te Co
mplet
e (St
anda
rd)
DY
Caro
tid D
uplex
Son
ogra
phy C
omple
te Co
mplet
e (St
anda
rd)
YD
Para
nasa
l Sinu
s Son
ogra
phy
Focu
sed a
nd Li
mited
Spec
ify
YY
Denta
l / or
al So
nogr
aphy
Focu
sed a
nd Li
mited
Extra
oral,
limite
dY
YSa
livar
y Glan
d Son
ogra
phy L
tdFo
cuse
d and
Limi
tedSp
ecify
YN
Ophth
almic
Sono
grap
hy -
Limite
dFo
cuse
d and
Limi
tedUn
ilater
al or
F/U
YY
Ophth
almic
Sono
grap
hy -
PLR
Focu
sed a
nd Li
mited
Pupil
lary R
eflex
YD
Jugu
lar V
ein S
onog
raph
y Spe
cific
Focu
sed a
nd Li
mited
Spec
ify S
cope
YD
Imag
e-Gu
ided V
ascu
lar A
cces
s (Int
erna
l Ju
gular
Vein
)Im
age-
guide
d ma
nipula
tions
NN
Rem
ote/
Isol
ated
loca
tions
Rem
ote/
Isol
ated
loca
tions
In th
is e
xam
ple
In th
is e
xam
ple
(NE
EM
O):
(NE
EM
O):
Eng
inee
r Ope
rato
rE
ngin
eer O
pera
tor
Rea
lR
eal -- t
ime
guid
ance
tim
e gu
idan
ce
thro
ugh
Vid
eo
thro
ugh
Vid
eo
Con
fere
ncin
g U
nit
Con
fere
ncin
g U
nit
~364
K~3
64K
Dig
ital I
mag
es p
ost
Dig
ital I
mag
es p
ost
exam
(~1
hour
)ex
am (~
1 ho
ur)
Cre
w M
edic
al O
ffice
rC
rew
Med
ical
Offi
cer
In th
is e
xam
ple
(Det
roit
In th
is e
xam
ple
(Det
roit
Red
win
gs):
Red
win
gs):
Ope
rato
r O
pera
tor ––
Ath
letic
A
thle
tic
Trai
ner
Trai
ner
Rea
lR
eal -- t
ime
rem
ote
time
rem
ote
guid
ance
thro
ugh
guid
ance
thro
ugh
Inte
rnet
con
nect
ion
Inte
rnet
con
nect
ion
--D
SLD
SL Inte
rnet
In
tern
et
vide
ocon
fere
ncin
gvi
deoc
onfe
renc
ing
Raw
dat
a se
nt n
ear
Raw
dat
a se
nt n
ear --
real
real
--tim
e to
radi
olog
ytim
e to
radi
olog
yR
evie
w /
man
ipul
atio
n of
R
evie
w /
man
ipul
atio
n of
3D
raw
dat
a se
ts d
urin
g 3D
raw
dat
a se
ts d
urin
g an
d po
st e
xam
inat
ion
and
post
exa
min
atio
n
Phys
icia
n O
nPh
ysic
ian
On --
site
site
In th
is e
xam
ple
In th
is e
xam
ple
(Sou
th P
ole)
:(S
outh
Pol
e):
GP
ope
rato
rG
P o
pera
tor
Mon
itorin
g of
M
onito
ring
of
radi
al
radi
al F
xFxhe
alin
ghe
alin
g
Met
hodo
logy
for O
ther
med
ical
Pro
cedu
res
Met
hodo
logy
for O
ther
med
ical
Pro
cedu
res
Exam
ple:
Mic
roEx
ampl
e: M
icro
-- Lap
aros
copy
Lapa
rosc
opy
CO
NC
LUSI
ON
SC
ON
CLU
SIO
NS
A w
ide
arra
y of
ultr
asou
nd a
pplic
atio
ns is
A
wid
e ar
ray
of u
ltras
ound
app
licat
ions
is
avai
labl
e fo
r the
Sur
geon
to o
rder
on
ISS
avai
labl
e fo
r the
Sur
geon
to o
rder
on
ISS
Join
t effo
rts o
f Spa
ce M
edic
ine
and
HR
F,
Join
t effo
rts o
f Spa
ce M
edic
ine
and
HR
F,
enha
nced
by
the
AD
UM
exp
erim
ent,
prov
ide
enha
nced
by
the
AD
UM
exp
erim
ent,
prov
ide
stro
ng m
etho
dolo
gy fo
r:st
rong
met
hodo
logy
for:
Sci
ence
use
s of
ISS
ultr
asou
ndS
cien
ce u
ses
of IS
S u
ltras
ound
Oth
er s
pace
med
ical
pro
cedu
res
Oth
er s
pace
med
ical
pro
cedu
res
Dev
elop
men
t of m
edic
al s
yste
ms
for f
utur
e D
evel
opm
ent o
f med
ical
sys
tem
s fo
r fut
ure
mis
sion
sm
issi
ons
Sub
stan
tial t
erre
stria
l app
licat
ions
Sub
stan
tial t
erre
stria
l app
licat
ions
CO
NC
LUSI
ON
S C
ON
CLU
SIO
NS
-- 22
The
ISS
has
allo
wed
to c
lear
ly id
entif
y ch
alle
nges
of
The
ISS
has
allo
wed
to c
lear
ly id
entif
y ch
alle
nges
of
rem
ote
ultra
soun
d an
d de
vise
sol
utio
ns to
tech
nica
l re
mot
e ul
traso
und
and
devi
se s
olut
ions
to te
chni
cal
and
proc
edur
al c
halle
nges
and
proc
edur
al c
halle
nges
Luna
r ultr
asou
nd s
olut
ions
are
see
n as
a s
erie
s of
Lu
nar u
ltras
ound
sol
utio
ns a
re s
een
as a
ser
ies
of
upgr
ades
to th
e IS
S u
ltras
ound
sys
tem
, with
the
upgr
ades
to th
e IS
S u
ltras
ound
sys
tem
, with
the
follo
win
g co
mm
on p
rinci
ples
:fo
llow
ing
com
mon
prin
cipl
es:
Min
imal
ly tr
aine
d op
erat
orM
inim
ally
trai
ned
oper
ator
Dis
tribu
ted
expe
rtise
Dis
tribu
ted
expe
rtise
Ada
ptiv
e ex
perti
se d
eliv
ery
Ada
ptiv
e ex
perti
se d
eliv
ery
Focu
sed
exam
inat
ions
with
prio
ritiz
ed p
roce
dura
l Fo
cuse
d ex
amin
atio
ns w
ith p
riorit
ized
pro
cedu
ral
sequ
ence
sse
quen
ces
Que
stio
ns?
