ESA relies on GMV to monitor the health of astronauts

Space medicine specialists from the European Space Agency (ESA) have put their trust in the multinational technology firm GMV for the ALISSE project. The goal is to develop an artificial intelligence technology based on deep learning, to guide and assist astronauts in capturing ultrasound images with high diagnostic quality, with a focus on organs that can be affected by the conditions of human spaceflight. These images will facilitate the work of specialized physicians, who will be able to diagnose health problems in the astronauts at an early stage, remotely from Earth. Treatments can then be applied to address any issues detected. The project’s clinical partner is the Emergency Radiology Unit at La Paz University Hospital, which is directed by Milagros Martí de Gracia. In addition, collaborating researchers from the Nuclear Physics group at the Complutense University of Madrid (UCM), led by Jose Manuel Udías Moinelo, will be generating extremely realistic simulations. These will be used to improve the robustness of the system, so that it can be applied in an environment as unknown as outer space.

Astronauts are professionals known for their good health. They have perfect vision, good physical fitness, flexible and well‑developed muscles, and manual dexterity. However, space is a very hostile environment for the human body. Many of our organs are susceptible to problems caused by the absence of gravity in space, or by exposure to cosmic radiation. The effects of space can also cause loss of bone and muscle mass, impaired liver function, increased probability of kidney stones and blood clots, farsightedness, etc. Cosmic radiation also produces some very negative effects on the spleen, immune system, and heart.

Not only can these pathologies have a significant impact on an astronaut’s performance, they can also lead to further medical complications that may require surgery or a return to Earth. In fact, before they are launched into space, astronauts receive a 40‑hour medical training course, so that they will be able to address common health problems, such as during a 6‑month stay in orbit on the International Space Station (ISS). One of the ISS astronauts is also designated as the Crew Medical Officer (CMO).

Currently, the only medical imaging equipment onboard the ISS is an ultrasound machine. This is because ultrasound equipment has unique characteristics that make it ideal for space missions, such as a lack of harmful side effects, reduced size, and ability to obtain real‑time images. However, it is difficult to learn the techniques that must be applied with this type of equipment in order to correctly produce images with clinical value. Indeed, years of specialized training in radiology and instruction from experts is required. It is therefore hard for astronauts to master this type of diagnostic imaging while at the same time receiving very intensive training in a wide variety of other fields.

When ultrasound has been used on the ISS up until now, the relative proximity to Earth has allowed the medical team on the ground to give the astronauts guidance through videoconferencing.  However, during missions when distances from Earth are greater, there are delays in receiving images and communications. This makes accurate medical exploration more difficult for the astronauts, and working via videoconferencing is no longer a feasible way to obtain accurate medical images that can be used for diagnosis.

The challenges of manned space missions

Exploration of interplanetary space, the planned Lunar Gateway international space station that will orbit the moon, and future manned missions to Mars are all bringing up new challenges, and the health of the astronauts must be given top priority.

During a hypothetical mission to Mars, the crew will be at a distance of 54 to 402 million kilometers from Earth, so any return to the ground to receive urgent medical treatment will not be a feasible option. Telemedicine and remote guidance will also be insufficiently effective, because of the quality of the images being transmitted and the delays affecting radio communications, which would take up to 20 minutes to travel from Mars to Earth (with the same amount of time required to receive a reply). To address this situation, GMV is proposing a solution that allows personnel without specialized training in radiology to obtain clinically relevant ultrasound images of the organs. These can then be sent to Earth for analysis and interpretation by specialized physicians.

As explained by Carlos Illana, head of the Secure e-Solutions product at GMV, “in the ALISSE project research is being performed on new artificial intelligence techniques, to guide and assist crew members so they can acquire diagnostic-quality images. These techniques are designed to eliminate the need for interactive consultation with specialized physicians on the ground when those images are being produced. This will allow early detection and diagnosis of any health problems the crew members are experiencing while in space, and evolution of their situation can be monitored using these ultrasound images.”

The software that GMV is developing in the ALISSE project will assist with ultrasound imaging studies based on protocols for each organ, and it will provide real‑time guidance for any crew member with a basic knowledge of anatomy. For example, in a case involving an inflamed kidney that may have become swollen because of a kidney stone, GMV’s solution will provide suggestions on how to position the ultrasound probe and adjust the machine’s settings (acoustic power, depth, gain) to obtain the highest quality image. It will also allow the cross-sections being captured and those being used for reference to be viewed at the same time for comparison.

As the expert from GMV explains, “we are proposing development of a new computer-guided ultrasound technology with a specialized focus, which is application of artificial intelligence with deep learning”. This approach is taking advantage of the experience gained during previous research involving these architectures, in order to explore other new ones. This will make it possible to address challenges such as the need to guide positioning of the probe, detect standardized cross-sections with high diagnostic value, generate realistic ultrasound data, and adjust the gain and depth settings to improve image quality. All of this is being done thanks to clinical support from the Emergency Radiology Unit at the La Paz Hospital, with participation by Dr. Diez Tascón, Dr. Alonso, Dr. Parra, Dr. Ossaba, and Dr. Garzón, who is the head of the hospital’s Radiology Department and Principal Investigator for the project. The project is also benefitting from additional collaboration by the Nuclear Physics group at the Complutense University of Madrid (UCM), to further improve and apply the most advanced techniques in Smart Ultrasound Imaging.

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