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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?
