Medical Milestone In Space: First X-Rays Of Astronauts In Orbit Successfully Captured

For more than 40 years, when something went wrong with an astronaut’s body in orbit, doctors had one reliable way to look inside the body: ultrasound. Useful, yes, but the same technology used to check on babies in the womb is far from a complete medical toolkit. Now, for the first time in spaceflight history, X-rays have been taken in orbit, and the results show that space medicine just got a serious upgrade.

During the Fram2 mission, which launched on March 31, 2025, aboard a SpaceX Falcon 9 rocket and spent roughly three and a half days circling Earth in a polar orbit, crew members operated a portable, off-the-shelf digital X-ray system to image their own bodies, with only four hours of prior training. Those images came back diagnostically adequate, meaning doctors reviewing them on the ground could use them to evaluate a patient’s health. As humans travel farther from Earth, relying on a single way to look inside the body becomes harder to justify, and this mission cracked that limit open.

Published in the journal Radiology, the study reached past human medicine. Crew members also aimed the same device at a smartwatch and at a test object, a first look at whether X-rays could help inspect spacecraft hardware for hidden damage without anyone taking it apart.

Taking X-Rays in Space With Four Hours of Training

Three of the four Fram2 crew members, two women and one man averaging about 43 years old, agreed to take part. Using a portable, battery-powered digital X-ray generator and a wireless flat-panel detector, both commercially available and cleared by the U.S. Food and Drug Administration, they imaged their hands, forearms, chests, abdomens, and pelvises. A quality-control test object and a Garmin Fenix 7 smartwatch rounded out the targets, chosen to test whether the system could see inside equipment without anyone dismantling it.

Before the mission, crew members received about four hours of hands-on training, passed along in a chain: staff from the equipment companies first trained SpaceX personnel, who in turn trained the astronauts. That is a short runway for learning to run medical imaging gear. Each participating crew member also worked through the full imaging protocol on the ground before launch, producing a baseline set of images for later comparison.

In orbit, imaging happened on the first and third days after launch. Time pressure meant not every planned image got captured. Only two of the three participating crew members managed in-flight imaging at all, and one crew member reported not being able to get a chest image, likely because the clock ran out. Crew members reviewed and accepted or rejected every image themselves, with no live coaching from the ground. Static picture guides and written steps were the only help on hand.

Space X-Ray Quality Held Up, With One Exception

Back on Earth, three independent radiologists scored every image on four measures: overall quality, sharpness, contrast, and positioning. None of them knew which images came from space and which came from the ground. They graded on a five-point scale, where anything at or above a three counted as good enough for medical use.

Scores held steady across nearly every measure. Overall quality, sharpness, and contrast showed no meaningful difference between the orbit images and the pre-launch ones. Every single image earned at least a four out of five for overall quality, landing in the “good” or “excellent” band, even with no mounts or clamps to brace the equipment in weightlessness.

One measure broke the pattern: positioning. For images of the central body, meaning the chest, abdomen, and pelvis, in-flight scores came in clearly worse than the pre-flight ones, and this was the only difference large enough to be statistically real. Average positioning scores fell from about 4.95 before the mission to about 4.07 in orbit. That still sits inside the “good” range, yet the gap held up under testing. Hand and forearm images showed no such slide, probably because a limb is easier to press flat against a detector while floating.

Survey responses gathered two days after splashdown matched what the scores showed. All three crew members rated the equipment easy to use and the protocol easy to follow. Their sticking point was physical alignment, and every one of them asked for better mounting hardware on future flights. Lining up the X-ray source, the detector, and the body part in weightlessness, with nothing to anchor any of it, ranked as the hardest part of the job.

Beyond Medicine: X-Rays as a Spacecraft Safety Check

Beyond medical imaging, the X-ray system showed off something that could matter just as much for mission safety: a way to look inside equipment without opening it up. When the crew aimed the device at a Garmin Fenix 7 smartwatch, the resulting picture clearly showed the watch’s internal components at a scale smaller than one millimeter.

Spacecraft carry systems, spacesuits among them, that can’t easily be taken apart in orbit for a look inside. An X-ray tool that reveals hidden structural damage or manufacturing flaws without any disassembly could earn a place on long missions as a safety instrument as well as a medical one. For now the trick works only on hardware small enough to fit between the generator and the detector, which leaves out large structures and broad habitat surveys.

Radiation is the obvious worry, and the study met it head-on. Astronauts already soak up more radiation in orbit than most people on the ground typically do. Over the whole 3.5-day flight, onboard dosimeters recorded a total of 1.5 millisieverts (a standard unit of radiation exposure) from the space environment and the imaging combined, about 10% above what a crew member on the International Space Station absorbs in a single day.

Estimated separately, each participant’s share from the X-ray system alone ranged from 0.3 to 2.7 millisieverts, depending on how many images they sat for, a range the authors put on par with ordinary medical imaging back on Earth. Nearby crew members picked up only a sliver of scattered radiation during imaging.

After the capsule splashed down in the Pacific Ocean on April 4, 2025, engineers went over the gear. Landing left the X-ray generator with cosmetic bruises, bent guards and a cracked plastic lens, though its internal parts and its output came through fine. Its detector passed every quality test, and post-flight images shot by non-crew staff using the same steps were indistinguishable from what the crew had captured in orbit.

Researchers are upfront about the limits. Only three people took part, all of them healthy and able-bodied, and the brief mission left little room to troubleshoot or retake a badly positioned shot. This crew worked without live ground support, leaning on static picture guides and written steps, and real-time medical coaching from the ground may not be practical at all on trips to the Moon or Mars, where communication delays could leave a crew leaning harder on its own training and onboard tools.

Reach could stretch well beyond space, too. Researchers note that portable, rugged digital X-ray units with remote reading are already at work in conflict zones, isolated communities, and places with thin medical infrastructure. Gains pushed by spaceflight, meaning smaller equipment, better software, and smarter positioning aids, could feed straight back into those settings.

For decades, space medicine worked around the limits of ultrasound because there was no other option. A crew member with four hours of training and a commercially available X-ray device can now produce diagnostically adequate images while floating hundreds of miles above Earth. For the era of deep space travel, that is a brand-new capability.

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Disclaimer: This article is for general information and does not provide medical or radiation-safety advice.