SpaceX Fram2 Mission Achieves First Orbital X-Rays

The SpaceX Fram2 mission, which concluded in early April 2025, has achieved a historic milestone in space exploration by capturing the first medical X-rays ever taken during an orbital flight. Four amateur astronauts aboard the mission successfully operated a portable X-ray machine to scan various body parts and equipment, demonstrating the feasibility of in-orbit radiography for diagnostic purposes. The findings were recently published in the journal Radiology.

For decades, ultrasound has been the primary medical imaging tool available to astronauts, but its limitations, particularly with bone imaging and operator training, have become increasingly apparent as missions extend in duration and distance. This new development, spearheaded by lead researcher Sheyna Gifford, an assistant professor of aerospace medicine at Mayo Clinic, offers a more robust and versatile imaging solution.

"X-ray is one of the most powerful diagnostic tools in modern medicine because of its speed, accuracy, and ability to be operated by a broad range of people without the need of a sound transmitting medium," Gifford stated. "In the case of space, we would also be relieved to know whether or not our spacesuit glove had a hole in it, our rock pick was about to break from a stress fracture, and if the rock we picked up on our Moon walk contained the right minerals. A spectral X-ray system can help address all of these needs in the same set of equipment."

Advancing Aerospace Medicine

The Fram2 mission, a 3.5-day polar orbital flight, served as a crucial testbed for this new capability. Before launch, three crew members underwent approximately four hours of operator training, enabling them to capture preflight images. The mission, which launched on March 31, 2025, aboard a SpaceX Falcon 9 rocket, placed a Crew Dragon capsule into a 90-degree orbit between 264 and 280 miles above Earth. During the flight, the crew utilized a commercial off-the-shelf portable X-ray device to scan anatomical regions such as the hand, forearm, abdomen, pelvis, and chest. Beyond human anatomy, they also scanned a smartwatch, assessing the machine's ability to diagnose issues with electronics or equipment at a micron scale.

The mission returned to Earth on April 4, 2025, splashing down near Oceanside, California. While the X-ray generator experienced minor superficial damage during landing and recovery, its core functionality and X-ray output remained unaffected. Following the mission, an operator not part of the flight crew conducted postflight X-rays to compare with the preflight and inflight scans. Three independent radiologists then assessed all images, confirming that the in-flight scans were of diagnostic quality, with comparable resolution and positioning to those taken on Earth.

The limitations of ultrasound in space were a primary driver for this research. Gifford elaborated on these challenges, noting that while ultrasound is effective for certain tissues, it struggles with bone detail and requires significant operator skill. "For ultrasound to work, the injury or illness for which you are looking must be present in a medium responsive to sound waves," she explained. "A skilled ultrasound technician may know the best scanning angle to try for some small amount of sound wave penetration into bone, but the internal structure of the bone will often remain a mystery on ultrasound." This lack of detail is particularly concerning given the increased risk of fractures and injuries during future lunar missions, where even the Moon's reduced gravity poses challenges.

The ability to perform X-rays in orbit opens up new avenues for medical assessment and equipment inspection. Beyond diagnosing potential bone fractures or internal injuries, the technology could be used to inspect critical gear, such as spacesuit gloves for damage or structural weaknesses in equipment. This broad applicability is vital as humanity prepares for more ambitious, longer-duration missions. Gifford envisions future X-ray systems for spaceflight being even more compact and robust, capable of withstanding vacuum conditions for use during extravehicular activities. Integrating real-time guidance and support could further enhance their accessibility, not only for astronauts but also for patients in remote or underserved communities on Earth.