IEEE PULSE presents

Space-Age Tech Goes to the Clinic

Feature July/August 2014

Anyone who has ever watched video of the now-retired U.S. space shuttle performing a mission such as repairing the Hubble telescope or of astronauts at the International Space Station (ISS) installing a new station module or solar panel has seen some of the world’s most sophisticated robots in action—a set of multijointed remote-controlled arms that, with their ability to both translate and rotate in any direction, allow six degrees of freedom in their movements.
But perhaps the most amazing thing about these long, powerful, and nimble arms is not what U.S. and international astronauts have been able to accomplish with them over decades in space but what they have led to—as a completely unexpected spinoff, a serendipitous bonus. That bonus was the transfer of that technology to robotic arms now being used for surgery here on Earth, potentially saving lives by allowing an experienced neurosurgeon to continue operating, by remote control, while the patient is deep inside a magnetic resonance imaging (MRI) machine that provides real-time imaging of the living brain and the tumor on which is being operated. This technology, along with other versions of telerobotic surgery systems in use or under development by several companies, could ultimately be used by surgeons in one place to manipulate tools to aid patients halfway around the world.
Produced under the name neuroArm by IMRIS, Inc., in Winnipeg, Canada, this technology was a direct offshoot of work done by another Canadian company, MDA, starting in the 1970s. MDA developed the robotic Canadarm and Dextre, the space shuttle and ISS manipulator arms used to heft satellites out of the cargo bay or allow astronauts to perch for a repair job.
The robotic arm has been used on hundreds of patients in clinical trials and is awaiting final approval and has already been chosen for interactive demonstrations on the ISS to show its capabilities for eventual  telemedicine. Meanwhile, the development team, led by Dr. Garnette Sutherland of the University of Calgary, is now working apace on development of its successor, neuroArm 2.

Terrestrial Benefits from Extraterrestrial Excursions

As noted, neuroArm was an unexpected bonus from the human spaceflight program, but such unforeseen benefits are far from rare, as can be seen in Figure 1. NASA is fond of pointing out that money invested in the space program actually gets spent here on this planet; however, the terrestrial benefits of the money spent on space technology have gone far beyond supporting a few aerospace companies and sustaining the direct and indirect jobs on which they depend. The need to solve pressing issues for the sustenance and protection of crews in space has often led to substantial direct benefits in technologies, techniques, and lessons that affect the lives and well-being of ordinary people.
Not counting the obvious payoff for biomedical technology from the research projects directly aimed at such development, health and biomedical spinoffs from work in space have tended to fall into four broad categories:

  • inventions resulting from further development of mechanical devices intended to solve spacecraft issues completely unrelated to health, such as the neuroArm, as well as a heart-assist pump that was an outgrowth of a device measuring rocket-engine fuel flow
  • inventions resulting from the need to protect the health and well-being of astronauts in the unnatural environment of space, such as high-efficiency, lightweight filters for the air and water that are now used as air filters for health care facilities and water-purification systems in remote, off-grid villages
  • materials developed for the specific needs of space operations and equipment that then turned out to have entirely different uses, such as shape-memory metals now used for eyeglass frames (see “Lasik Surgery—Better Eyesight, Thanks to Space Travel”)
  • health-related inventions that resulted from unexpected observations of the effects of extreme conditions on astronauts and test animals aboard the shuttle and the ISS, and methods derived to counteract those changes.

[accordion title=”Lasik Surgery—Better Eyesight, Thanks to Space Travel”]
Should you ever have the opportunity to have your blurred, hazy vision zapped into perfect 20/20 clarity, you can thank the lucky stars—or at least our impetus to travel toward them.
Lasik surgery, first introduced in the 1990s, is one of the world’s most widely practiced surgical procedures, and, as it turns out, some of its enabling technologies were a direct offshoot of space travel—in this case, technology developed for robotic spacecraft navigation.
The technology for laser-guided Lasik came out of a project at NASA’s Johnson Space Center starting in the 1980s, called LADAR, to enable automated rendezvous-and-docking maneuvers for servicing satellites in orbit. It turns out the requirements for eye surgery and docking spacecraft are very similar: the need to lock two independent objects precisely in sync with each other, compensating for every jolt, jitter, and sway, so that the relative motion between the two is essentially zero. The systems NASA worked out to lock the coordinates of one spacecraft perfectly to another approaching it led very directly to a system for tracking tiny motions of the eye and using that data to compensate by moving the laser accordingly. The system was licensed by the U.S. Food and Drug Administration for use in laser surgery in 1998.
The advances in eye care did not stop there. Wavefront Sciences, a small company in Albuquerque, New Mexico, has developed a device for mapping the topography of the human eye. Called the Complete Ophthalmic Analysis System, it can measure the detailed shape of the eye faster and more accurately than previous systems, and is now incorporated in some new Lasik machines available in Europe. This technology was developed as a result of a testing system designed by NASA to analyze the surfaces of the giant mirrors being manufactured as the heart of the new James Webb Space Telescope, which is scheduled to replace the Hubble Space Telescope in 2018. Each of the telescope’s 4.3-ft wide mirror segments, 18 of them in all, had to go through a rigorous grinding and polishing process that involved constant regrinding and retesting over a period of months. The new technology streamlined that process.
It turns out that getting a good look at things up in space has also helped give us a better view of things here on Earth.
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For example, in the last category (devices developed to help astronauts deal with their circumstances but now being applied to earthbound patients) is a flow-monitoring device that measures molecules of nitrous oxide in a person’s exhaled air. Developed in cooperation with the European Space Agency to detect signs of developing infection or inflammation in an astronaut before symptoms arose, an offshoot of that initial device is now being marketed by its developer, Swedish company Aerocrine AB, as a portable diagnostic tool to be used in health centers. The device, called NiOx Mino, is useful for asthmatics to detect an incipient attack before it hits.
Similarly, another company called Ionworks, based in Houston, Texas, developed a mass analyzer for measuring multiple kinds of gas levels inside the space shuttle. This led to a set of large-molecule detection devices that could be used to spot contamination on surfaces as well as in the air. The same mass analyzer concept has been used to detect certain biomarker molecules in brain-injury and addiction research being carried out under the National Institutes of Health.
Another device that was developed to maintain the health of astronauts was a small, handheld ultrasound device for multipurpose diagnostics, which takes the place of a whole suite of imaging systems used at a hospital on Earth, ranging from MRI to computed tomography scans. Under development by Mediphan in collaboration with the Henry Ford Hospital in Detroit, Michigan, and Wyle Laboratories in Houston, the device can be used to monitor everything from teeth and sinuses and joints to neural health by measuring changes in the diameter of the eye’s optic nerve sheath. It is also capable of producing diagnostic images of many organs and tissues. The device recently has been used to perform checkups on Olympic athletes and remote mountain climbers, and is now being used in many hospitals as well.
NASA research aimed at making packaged food last longer without spoiling led to an air-cleaning system that can eliminate a wide variety of airborne pathogens, including mold, fungi, bacteria, viruses, and volatile organic compounds. The device is now being commercialized for food-processing facilities. Similarly, an airfiltration system originally developed to keep contaminated air from escaping from a test greenhouse on the ISS has been developed into an inexpensive system now being used in some health care facilities.

Timeline of Advances

The following timeline shows the many important advances in technology that have had their origins in devices developed for use in space. (Photos courtesy of the Center for Advancement of Science in Space.)
1997-2005
2007-2011

From Orthopedic Implants to Medical X-Ray Systems

A variety of systems developed for one purpose have ended up being useful in entirely different areas. For example, some basic materials research on an exotic category of compounds called undercooled liquids led to a product called Liquidmetal. It is said to be twice as strong as titanium, yet can be molded and has a flexibility similar to that of plastic. Developed mainly for items such as baseball bats and cellphone housings, it has turned out to be well suited for some types of orthopedic implants.
A very different kind of useful offshoot came from a project designed to detect x-rays and gamma-rays from solar eruptions, which could pose severe health risks for astronauts unless they seek shelter in a shielded compartment. A small start-up company called Mikro Systems developed a manufacturing process for fine mesh grids of tungsten to make highly sensitive, high-resolution detectors. Not only has the system been used to collect tens of thousands of images of solar flares, it has now been commercialized for use in medical x-ray systems.
In an entirely different way, a set of technologies developed for astronomical imaging has begun to provide potentially life-saving information at a human scale. This time, the innovation came from the Jet Propulsion Laboratory (JPL) in Pasadena, California, the NASA center that manages most of the missions of planetary exploration. JPL is subjected to one of this planet’s most overwhelming deluges of data, literally millions of new images of different planets, moons, asteroids, and comets being beamed back from robotic spacecraft every day. So, JPL has developed a suite of image-processing software designed, among other things, to tease out barely visible details without introducing any processing artifacts in the process. This sophisticated software, constantly evolving and improving since 1966, is called Video Imaging Communication and Retrieval and is now a highly sophisticated package of image processing and analysis programs.
That software led directly to the development of a medical imaging analysis program called Arteriovision, which can perform automated analysis of scans of carotid arteries. In early testing, the device performed amazingly when it provided very strong evidence of extreme plaque buildup in one patient that had eluded detection through many tests using standard methods. The device is being commercialized by a company called Medical Devices International Inc., in Palm Desert, California. It is in use in all 50 states and in many countries around the world.

Pushing to the Outer Limits

Nobody could have foreseen some of these outcomes. And few would have predicted that teaching a computer how to tease out the fine differences in mineral types of rocks on the surface of Mars or the subtle patterning in Saturn’s gossamer rings might lead directly to technology that can tell you if you’re in imminent danger from arteriosclerosis.
But it is not surprising that after more than five decades of launching both things and people into space—into unforgiving and relentlessly hostile remote environments removed from any hope of rescue or outside aid—scientists have pushed to the very limits of what the latest technology can accomplish. And it is also not surprising that those boundary-busting technological leaps would in turn be harnessed in aid of what we care most deeply about—saving the lives and health and well-being of those here on Earth.
Whether it’s a simple air filter at a clinic in a small town in Bolivia or a portable ultrasound diagnostic kit in a village health center in Tanzania, the most advanced eye surgery machinery in a facility in Germany, a knee implant at a hospital in New York, or dozens of places and technologies in between, solving the problems that arise in space continues to lead to a range of biomedical technologies and methods. It’s a kind of unexpected manna from the heavens.

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