For the first time, diagnostic X-ray images have been successfully captured in orbit, using a portable commercial radiography system aboard a SpaceX commercial spaceflight. The achievement, published today in the journalRadiologyby the Radiological Society of North America, represents a significant step forward for medical imaging capabilities during space missions.
For more than four decades, ultrasound has been the only reliable medical imaging method available in space. However, as missions grow longer and travel farther from Earth, the limitations of ultrasound have become increasingly apparent. Ultrasound requires significant operator training and depends on sound wave transmission through a suitable medium, which can be problematic in certain medical scenarios.
«Having more than one imaging modality to diagnose disease and trauma in space has long been a goal of aerospace medicine,» said Dr. Sheyna Gifford, lead author of the study and a professor of aerospace medicine at the Mayo Clinic in Rochester, Minnesota. «X-rays are fast, simple to perform, and of great diagnostic value.»
The research team collaborated with SpaceX to test a portable X-ray system during Fram2, a three-and-a-half-day polar orbital mission. The system used was a commercially available, off-the-shelf portable digital radiography device, chosen for its compact size and ease of use. Traditional X-ray equipment has been considered too bulky, high-radiation, and prone to motion blur for space applications, as everything in orbit is constantly in motion.
«Portable X-ray equipment is already used in many settings, from the Kentucky Derby to the sidelines of the Super Bowl to resource-limited areas of the world, because it can run on solar power and be operated by people without medical training,» Gifford explained. «We were convinced that a standard commercial system had a very good chance of passing pre-launch tests and being used in space by crew members with minimal training.»
Before the mission, three civilian crew members received four hours of training on the portable X-ray system. SpaceX personnel also conducted shock resistance and spacecraft compatibility tests. Prior to launch, X-rays were taken of the hand, forearm, abdomen, pelvis, and chest. The Fram2 mission launched on March 31, 2025, aboard a SpaceX Falcon 9 rocket, reaching a polar orbit of 90 degrees at an altitude between 425 and 450 kilometers. The mission lasted 3 days and 14 hours, ending with a return to Earth on April 4, 2025.
During the flight, without any ground support, crew members acquired X-ray images of a calibration phantom, a smartwatch, and anatomical regions including the hand, forearm, abdomen, pelvis, and chest. The images were transmitted immediately to an onboard computer and evaluated by the crew. After landing, additional X-rays were taken to replicate the pre-flight and in-flight exams. Three independent radiologists assessed all images for overall quality, resolution, and diagnostic value.
The portable X-ray generator sustained minor superficial structural damage during landing and recovery operations, but internal components and radiographic performance remained unaffected. The study highlights that a space-ready X-ray system has profound implications not only for crew health but also for non-medical operational tasks, such as inspecting electronic components and spacesuits without disassembly.
«To ensure a stable human presence in space, X-rays are essential not only for astronauts but also for checking the condition of components like electronics and spacesuits,» Gifford said. «The only way to examine the inside of these objects without taking them apart is to use X-rays.»
This proof-of-concept mission demonstrates that portable X-ray technology can function reliably in microgravity with minimal crew training, opening the door to more comprehensive medical imaging capabilities on future long-duration missions to the Moon, Mars, and beyond.