Space Biomedicine Provides Insights into Bone Disorder Diagnosis, Fracture Healing

The technology will allow the early prediction of bone disorders such as osteoporosis and guided acceleration of fracture healing.

U.S. National Space Biomedical Research Institute (NSBRI; Houston, TX, USA) scientists are developing the technology to assist astronauts during long-duration spaceflight. Similar to elderly persons on Earth, astronauts in space lose bone structure and quality.

Dr. Yi-Xian Qin, associate team leader for NSBRI's smart medical systems and technology team, calls the new technology scanning confocal acoustic navigation (SCAN). He reported that the goal is to develop a small, mobile device that is easy to use and patient friendly. "SCAN uses noninvasive and nondestructive ultrasound to image bone. It will allow us to identify weak regions, to make a diagnosis, and to assist in healing fractures,” said Dr. Qin, who is also the director of the Orthopedic Bioengineering Research Laboratory at Stony Brook University-State University of New York (Stony Brook, NY, USA).

Stress-related fractures are a big problem for astronauts during long missions to the moon or in space. According to Dr. Qin, the fracture rate could be high on the moon due to workload force, heavy spacesuits and gravity that is one-sixth that of Earth.

The researchers are developing the new technology using scanning confocal acoustic diagnostic imaging for diagnosis and low-intensity pulsed ultrasound technology for treatment. Compared to current diagnostic ultrasound scanners, Dr. Qin's new technology is more advanced because of its ability to assess a higher number of parameters and is designed for imaging of hard tissue such as bone. "Our new ultrasound technology can detect bone mineral density. In addition, we can assess bone quality, such as stiffness, and then predict the risk of fracture,” Dr. Qin said. "Overall bone quality assessment, including strength and structure, is essential because the risk of fracture is probably more related to the quality of a bone rather than the density of a bone alone.”

On Earth, X-ray machines are the standard tools of choice for monitoring bone health, but they are only used to detect bone mineral density. X-ray machines are not suitable for use in space due to the health risk radiation poses to astronauts, who are exposed to higher levels of radiation outside of Earth's protective atmosphere and magnetic field.

Dr. Qin is currently conducting clinical evaluations of the diagnostic part of the technology. The mobile device runs off of a laptop computer, and an image of the heel or wrist can be completed in about five minutes. Also under development is the capability to scan the knee and hip.

Meanwhile, the group is continuing development of the therapeutic portion of the technology. On Earth, it takes six weeks to heal a fracture in normal conditions. The healing process may take longer in space. According to Dr. Qin, the device will help accelerate fracture healing by stimulating bone regeneration.

Ultrasound has been used to heal fractures, but it has not been effective due to its lack of accuracy at the fracture site. This is where Dr. Qin's guided approach will be advantageous. "We are trying to use ultrasound technology as a way to get an image of the fracture site,” Dr. Qin said. "An integrated probe will directly shoot ultrasound into the region of the fracture. We hope this will result in effective acceleration of fracture healing.”

SCAN technology should also be a helpful tool for healthcare providers on Earth who are dealing with an increasing elderly population and for those in rural areas where access to medical facilities is limited. In addition to being small and easier to use than X-ray-based bone density measurement machines, the ultrasound device could be as much as 10-times cheaper to purchase and operate. "If we can provide a cost-effective, easy to operate machine at the doctor's office, then they can monitor patients at minimal cost,” Dr. Qin said.

Dr. Qin's project is one of nine currently in the NSBRI Smart Medical Systems and Technology Team's range of studies devoted to developing new integrated medical systems to assist in delivering quality healthcare in space. Other areas being researched include space surgery and supporting techniques, routine risk and health-monitoring systems, and automated systems and devices to aid in decision-making, training, and diagnosis. The new systems will have immediate benefits for health care on Earth.

NSBRI, funded by the U.S. National Aeronautics and Space Administration (NASA; Washington DC, USA), is a consortium of institutions studying the health risks related to long-duration spaceflight. The Institute's science, technology, and education projects take place at more than 60 institutions across the United States.

Related Links:
National Space Biomedical Research Institute
Orthopedic Bioengineering Research Laboratory at Stony Brook University-State University of New York