NOTE: Title change in October 2009 (previous title, "Ultrasound Catalog for Autonomous Medical Care").

Terrestrial investigations suggest expanded clinical applications of ultrasound, which could be used to diagnose over 75% of space medical conditions. This proposal will use an outcomes oriented approach to develop an intuitive ultrasound image catalog, coupled with just-in-time training methods, to allow non-experts to acquire and interpret advanced ultrasound examinations.

Specific Aim 1: Develop an intuitive ultrasound image cataloging system which incorporates ground acquired ultrasound whole body images. The catalog will acquire ground based crew-member images to use for medical diagnosis in space.

Specific Aim 2: A mathematical coupling model will be developed based on existing ground/in-flight ultrasound data which will allow microgravity associated morphometric and topographic changes to be predicted.

Specific Aim 3: Assess the ability of non-physician crew medical officers (CMO) analogs to acquire and interpret complex ultrasound examinations autonomously or with remote guidance.

The constraints of spaceflight require the development of novel strategies for crew member health problems including ultrasound. Evidence based trials have demonstrated the accuracy of ultrasound in aerospace relevant clinical conditions when performed and interpreted by experts. ISS experiments have shown that just-in-time trained astronaut crew-members, augmented by on-board proficiency enhancement, can acquire complex, diagnostic quality ultrasound images. Expanding just-in-time ultrasound training to autonomous ultrasound operation, coupled with enhanced on-site interpretative capabilities, significantly expands diagnostic capabilities during exploratory class space missions. The majority of the training algorithms in this proposal are readily transferable to terrestrial medicine and provide a significant, clinically relevant advance in space medical capabilities with profound Earth-based ramifications.

United States Olympic Committee: We supported the 2010 Winter Olympic Games in Vancouver

National Football League: We are currently working with the Detroit Lions, Atlanta Falcons, and Chicago Bears

National Hockey League: Detroit Red Wings

American League Baseball: Detroit Tigers

National Basketball Association: Detroit Pistons

United Nations: Millenium Development Project, Team Leader Infopoverty Section

WINFOCUS: World Conference on Ultrasound, Critical Care Medicine Symposium

University of Michigan Center for Entrepreneurship: Technology Development

Wayne State University School of Medicine: used for medical student ultrasound education

American College of Surgeons: the Basic Ultrasound Course for Surgeons uses this technology.

Our ocular ultrasound technique to measure intra-cranial pressure is being tested in human trials in the ICU and was presented to the Armed forces. A number of spinoff companies, Medical Imagineering and Ultrasound Education Technologies, were formed to produce phantom ultrasound models, and ultrasound training videos, respectively. Major ultrasound manufacturers (GE, Sonosite) and simulation centers now use these products.

NOTE: Title change in October 2009 (previous title, "Ultrasound Catalog for Autonomous Medical Care").

Terrestrial investigations suggest expanded clinical applications of ultrasound which could be used to diagnose over 75% of space medical conditions. This proposal will use an outcomes oriented approach to develop an intuitive ultrasound image catalog, coupled with just-in-time training methods, to allow non-experts to acquire and interpret advanced ultrasound examinations.

Specific Aim 1: Develop an intuitive ultrasound image cataloging system which incorporates ground acquired ultrasound whole body images. The catalog will acquire ground based crew-member images to use for medical diagnosis in space.

Specific Aim 2: A mathematical coupling model will be developed based on existing ground/in-flight ultrasound data which will allow microgravity associated morphometric and topographic changes to be predicted.

Specific Aim 3: Assess the ability of non-physician crew medical officers (CMO) analogs to acquire and interpret complex ultrasound examinations autonomously or with remote guidance.

The constraints of spaceflight require the development of novel strategies for crew member health problems including ultrasound. Evidence based trials have demonstrated the accuracy of ultrasound in aerospace relevant clinical conditions when performed and interpreted by experts. ISS experiments have shown that just-in-time trained astronaut crew-members, augmented by on-board proficiency enhancement, can acquire complex, diagnostic quality ultrasound images. Expanding just-in-time ultrasound training to autonomous ultrasound operation, coupled with enhanced on-site interpretative capabilities, significantly expands diagnostic capabilities during exploratory class space missions. The majority of the training algorithms in this proposal are readily transferable to terrestrial medicine and provide a significant, clinically relevant advance in space medical capabilities with profound Earth-based ramifications.

We are currently 60% complete on developing the intuitive, autonomous catalog grant and have begun populating the backbone with normal and pathologic images. We met with astronaut Leroy Chiao recently for user feedback on the design of the catalog and user interface. We will acquire additional normal and pathologic images in an ongoing fashion.

Specific Aim 2: Develop a microgravity predictive, mathematical coupling model based on existing ground/in-flight ultrasound data which will allow microgravity associated morphometric and topographic changes to be predicted in the ultrasound catalog. The catalog will allow ground based crew-member organ system images to be acquired and stored in an enhanced format for medical operations personnel to use for medical diagnosis or research in space.

We have converted and decoded 3/4 of the ISS ultrasound imagery (over 20,000 total!) for population and integration into the intuitive catalog. We have MRI/US data on 4 subjects to date to determine the correlation between MRI and ultrasound for use in the catalog.

Specific Aim 3: Assess the ability of non-physician crew medical officers (CMO) analogs to acquire and interpret normal and pathologic ultrasound examinations using exam specific, cue cards and computer based proficiency enhancement autonomously or with remote guidance.

We have developed and verified cue cards for cardiovascular, renal, eye, and musculoskeletal examinations and have successfully used these aids to teach non-physician medical students to perform advanced ultrasound examinations. We have developed intuitive multimedia videos for the majority of the remaining exam sections included in the catalog and will test these with CMO analogs this summer.

Terrestrial investigations suggest expanded clinical applications of ultrasound which could be used to diagnose over 75% of space medical conditions. This proposal will use an outcomes oriented approach to develop an intuitive ultrasound image catalog, coupled with just-in-time training methods, to allow non-experts to acquire and interpret advanced ultrasound examinations.

Specific Aim 1: Develop an intuitive ultrasound image cataloging system which incorporates ground acquired ultrasound whole body images. The catalog will acquire ground based crew-member images to use for medical diagnosis in space.

Specific Aim 2: A mathematical coupling model will be developed based on existing ground/in-flight ultrasound data which will allow microgravity associated morphometric and topographic changes to be predicted.

Specific Aim 3: Assess the ability of non-physician crew medical officers (CMO) analogs to acquire and interpret complex ultrasound examinations autonomously or with remote guidance.

The constraints of spaceflight require the development of novel strategies for crew member health problems including ultrasound. Evidence based trials have demonstrated the accuracy of ultrasound in aerospace relevant clinical conditions when performed and interpreted by experts. ISS experiments have shown that just-in-time trained astronaut crew-members, augmented by on-board proficiency enhancement, can acquire complex, diagnostic quality ultrasound images. Expanding just-in-time ultrasound training to autonomous ultrasound operation, coupled with enhanced on-site interpretative capabilities, significantly expands diagnostic capabilities during exploratory class space missions. The majority of the training algorithms in this proposal are readily transferable to terrestrial medicine and provide a significant, clinically relevant advance in space medical capabilities with profound Earth-based ramifications.

We are currently 30% complete on developing the intuitive, autonomous catalog grant and have begun populating the backbone with normal and pathologic images. We met with astronaut Leroy Chiao recently for user feedback on the design of the catalog and user interface. We will acquire additional normal and pathologic images over the ensuing 8 months.

Specific Aim 2: Develop a microgravity predictive, mathematical coupling model based on existing ground/in-flight ultrasound data which will allow microgravity associated morphometric and topographic changes to be predicted in the ultrasound catalog. The catalog will allow ground based crew-member organ system images to be acquired and stored in an enhanced format for medical operations personnel to use for medical diagnosis or research in space.

We have converted and decoded 1/4 of the ISS ultrasound imagery (over 20,000 total!) for population and integration into the intuitive catalog. We have MRI/US data on 4 subjects to date to determine the correlation between MRI and ultrasound for use in the catalog.

Specific Aim 3: Assess the ability of non-physician crew medical officers (CMO) analogs to acquire and interpret normal and pathologic ultrasound examinations using exam specific, cue cards and computer based proficiency enhancement autonomously or with remote guidance.

We have developed and verified cue cards for cardiovascular, renal, eye, and musculoskeletal examinations and have successfully used these aids to teach non-physician medical students to perform advanced ultrasound examinations. We will continue this effort this summer with the remaining exam sections included in the catalog.

Terrestrial investigations suggest expanded clinical applications of ultrasound, which could be used to diagnose over 75 percent of space medical conditions. This proposal will use an outcomes-oriented approach to develop an intuitive ultrasound image catalog, coupled with just-in-time training methods, to allow non-experts to acquire and interpret advanced ultrasound examinations.

Specific Aims

1. Develop an intuitive ultrasound image cataloging system which incorporates ground-acquired ultrasound whole body images. The catalog will acquire ground-based crew member images to use for medical diagnosis in space.

2. Develops a mathematical coupling model based on existing ground/inflight ultrasound data which will allow microgravity-associated morphometric and topographic changes to be predicted.

3. Assess the ability of non-physician crew medical officer analogs to acquire and interpret complex ultrasound examinations autonomously or with remote guidance.

The constraints of spaceflight require the development of novel strategies for crew member health problems including ultrasound. Evidence-based trials have demonstrated the accuracy of ultrasound in aerospace-relevant clinical conditions when performed and interpreted by experts. ISS experiments have shown that just-in-time trained astronaut crew members, augmented by on-board proficiency enhancement, can acquire complex, diagnostic-quality ultrasound images. Expanding just-in-time ultrasound training to autonomous ultrasound operation, coupled with enhanced on-site interpretative capabilities, significantly expands diagnostic capabilities during exploration-class space missions.