ORBIT — Three crew members aboard the Fram2 polar orbital mission successfully captured diagnostic-quality X-rays in space on April 4, 2025, achieving the first human radiographs ever taken in orbit. The milestone demonstrates that portable radiography is feasible in microgravity and could expand medical and operational capabilities on future space missions.

The Fram2 mission launched on March 31, 2025, aboard a SpaceX Falcon 9 rocket and entered a 90-degree polar orbit at an altitude of 425 to 450 kilometers above sea level—the first human spaceflight to do so. Over its 3-day, 14-hour duration, the crew conducted a series of medical imaging experiments, culminating in the successful acquisition of in-flight X-rays just before the spacecraft returned to Earth on April 4, 2025.

Prior to launch, the three crew members—none of whom were medical professionals—underwent only four hours of training on a commercial-off-the-shelf portable radiography system. Despite minimal preparation and the challenges of microgravity, they acquired preflight images of a hand, forearm, abdomen, pelvis, and chest. In orbit, they repeated the process without any ground support, capturing X-rays of a calibration phantom, a smartwatch, and the same anatomical regions. The images were immediately transmitted to an onboard computer and reviewed by the crew during the mission.

Sheyna Gifford, MD, assistant professor of aerospace medicine at the Mayo Clinic in Rochester, Minnesota, and lead researcher of the study, said the success validates years of preparation. “The user-friendly design of our commercial-off-the-shelf system enabled rapid performance of numerous imaging examinations despite limited in-flight operational time, minimal crew training, and the absence of anchoring equipment in the microgravity environment,” Gifford said. She added, “Acquiring diagnostically useful x-rays in space is something that anyone can do.”

Gifford emphasized the historic nature of the achievement, noting that for more than four decades, ultrasound has been the only reliable medical imaging modality used in spaceflight. “It's been a dream for aerospace medicine to have more than one imaging modality for diagnosing illnesses and injuries in space,” she said. She also addressed long-standing skepticism: “Because everything in space is constantly moving, the conceit has been that obtaining a diagnostic image in orbit was too technically challenging.” Traditional X-ray machines, she explained, “are very large, produce a lot of radiation, and have a tendency to produce a blurred image if there's movement.”

The quality of both preflight and in-flight radiographs was evaluated by three independent radiologists using Likert scales. Results showed no statistically differences in overall image quality (mean scores of 4.86 in-flight versus 5.0 preflight, P>0.99), spatial resolution (4.86 vs. 5.0, P=0.46), or contrast resolution (4.86 vs. 5.0, P=0.46). However, image positioning for central radiographs of the chest, abdomen, and pelvis was worse in-flight, with mean scores of 4.07 compared to 4.95 preflight (P=0.02), suggesting room for improvement in stabilizing equipment.

After the mission, the crew completed a post-flight survey and unanimously agreed or strongly agreed that the X-ray system was easy to use and the protocol straightforward to follow. They also noted that improved mechanisms were needed to securely mount and clamp the X-ray detector and generator—a challenge anticipated in microgravity. SpaceX personnel had previously conducted impact and compatibility testing on the system to ensure it could safely operate within the Crew Dragon spacecraft.

Upon return to Earth on April 4, 2025, postflight X-rays replicating both preflight and inflight images were acquired for comparative analysis. The X-ray generator sustained superficial structural damage during landing and recovery, but internal hardware components and X-ray output remained fully functional, confirming the system’s resilience.

Gifford and colleagues had previously demonstrated the feasibility of X-ray imaging in simulated microgravity during a parabolic flight in 2022. Building on that work, they now suggest that further miniaturization, ruggedization, and improved usability could enable the inclusion of commercial-off-the-shelf radiography systems on future missions. Gifford broader applications: “A spaceflight-ready radiography system would have profound implications not only for crew health but also for mission-critical nonmedical tasks.” She added, “The only way to look inside these objects without taking them apart is to X-ray them.”

Gifford also pointed to terrestrial parallels, noting, “Portable X-ray machines are in use everywhere—at the Kentucky Derby, on the sidelines of the Super Bowl and around the globe in low-resource areas—because they can run on solar power and can be operated by individuals with no medical expertise.”

The study results were published in the journal Radiology, accompanied by an editorial from Suhny Abbara, MD, of the Mayo Clinic in Jacksonville, Florida, and Alan B. McMillan, PhD, of the University of Wisconsin-Madison School of Medicine. They wrote, “Portable, rugged, low-resource radiography systems with autonomous guidance could improve care in austere terrestrial settings, including disaster response, military medicine, remote communities, expeditionary environments, and low-resource health systems.” They concluded, “As our species crosses another boundary, from Earth to orbit and beyond, radiology is not merely following humanity into space; it is becoming part of the infrastructure that may make long-term exploration safer and more sustainable.”

The successful acquisition of diagnostic X-rays in orbit represents a critical expansion of in-flight medical capabilities. With ultrasound as the sole imaging tool in space for over 40 years, the addition of radiography could improve diagnosis of fractures, pneumothorax, bowel obstructions, and other conditions that are difficult to assess with sound waves alone. This advancement also supports nonmedical functions, such as inspecting hardware integrity without disassembly.

The experiment’s reliance on nonmedical personnel with minimal training underscores the potential for scalable, autonomous medical systems on future lunar, Martian, or deep-space missions where real-time ground support is impossible. The use of existing commercial equipment, validated through rigorous preflight testing and post-mission analysis, offers a practical pathway for integrating advanced diagnostics into spacecraft without extensive redesign.