Astronauts have long faced a medical handicap in space: the inability to take diagnostic-quality X-rays. However, a recent peer-reviewed study published in Radiology confirms that this handicap is now a thing of the past. During SpaceX’s Fram2 polar-orbit mission, three civilian crew members produced the first diagnostic-quality X-rays ever taken in orbital spaceflight.
The study found that the X-rays taken in space were of comparable quality to those taken on Earth. Independent radiologists who reviewed the images found no statistical difference between in-flight X-rays and pre-flight images in overall quality, spatial resolution, or contrast resolution.
Space medicine adopted ultrasound as its lone imaging tool due to its portability and ability to work in microgravity. However, ultrasound has real limits, including the need for substantial operator training and difficulty in reading images of bone, certain lung conditions, and internal injuries involving gas or air pockets.
According to Dr. Sheyna Gifford, lead researcher and assistant professor of aerospace medicine at Mayo Clinic, “X-rays are fast, easy, and diagnostically valuable.” The study’s findings support this statement, showing that X-rays can confirm or rule out a fracture in seconds, making them a valuable diagnostic tool.
The Fram2 mission launched from Kennedy Space Center on March 31, 2025, carrying four civilian crew members into a 90-degree polar orbit. During the mission, three of the four crew members enrolled in the study and received approximately four hours of training on the imaging system.
The crew then acquired pre-flight baseline images and, once in orbit, completed in-flight imaging using a commercial, off-the-shelf portable system. The system consisted of a MinXray Impact Wireless X-ray generator and a KA Imaging Reveal 35C flat-panel detector.
The detector’s single-exposure dual-energy subtraction capability produced two separate images from one X-ray pulse: a soft-tissue image and a bone image. This dual-energy approach also enabled quantification of areal bone mineral density, a measurement for tracking bone loss in space.
The X-ray generator and detector used in the study were not purpose-built for space but were instead commercial, off-the-shelf products. The team’s solution to the positioning problem in microgravity was to take the picture really, really fast, using a digital flat-panel detector that captures an entire image in milliseconds.
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This approach made portable orbital radiography possible, and the study’s results show that the system can produce high-quality images in space. The crew members who participated in the study rated the X-ray system and protocol as easy to use, and the images were transmitted immediately to an onboard computer for review.
In fact, the study’s findings have implications beyond just crew health, as the X-ray system can also be used for nonmedical tasks such as inspecting data lost in space and evaluating in-space manufactured components. As Dr. Gifford noted, “A spaceflight-ready radiography system would have profound implications not only for crew health but also for mission-critical nonmedical tasks.”
After the mission, all images were reviewed independently by three radiologists, who found no statistically significant difference in overall image quality, spatial resolution, or contrast resolution between in-flight and pre-flight radiographs.
The study’s authors identify the next technical requirements clearly: the system needs to be smaller, vacuum-hardened, and integrated with AI-assisted image interpretation tools. As the study’s discussion section notes, the hardware has cleared its proof-of-concept hurdle, but engineering optimization remains.
The study’s results have significant implications for future missions, particularly those to the Moon and Mars. With communication delays and no evacuation option, a Mars medical emergency requires the crew to diagnose and treat autonomously, making X-ray imaging a critical capability.
Dr. Gifford said, “For sustained human presence in space, X-rays are critical not just for crew members but also for other mission components like electronics and spacesuits.” The study’s findings bring us one step closer to making that presence a reality.
The authors call for several next steps, including standardized examination protocols, dedicated clamping mechanisms, and additional prospective studies to establish clinical guidelines for in-flight imaging. The bone mineral density data collected during Fram2 is still being analyzed and will be reported separately.
They are now working on optimizing the system for future use.