Many people take it almost as a given that they will receive prompt medical assistance and have immediate access to a hospital or medical care center in an emergency. Yet in these times of economic hardship and labor shortages, individual clinics and locations across Germany are facing closure.

“This often means that patients have to travel significantly further to access the services they need. People in rural areas, where medical care is already strained by a severe shortage of doctors, are hit especially hard. For this group, outpatient or inpatient treatment often involves additional travel and expense,” explains Dr. Diana Maier, researcher in the “Health Systems” department at Fraunhofer ENAS, as she describes the current healthcare situation in Germany.

According to Diana Maier, the situation is particularly serious for people with limited mobility. Gaps in the healthcare infrastructure in rural areas make it harder for them to obtain a prompt medical assessment at the nearest health center or hospital – for example, following a fall at home.

 

Shorter Journeys: Radiology That Comes to the Patient

“A mobile and portable X-ray system that medical professionals can take with them on any house call could be a real asset in such cases. This type of rapid diagnostic testing directly in the patient’s home makes it possible to distinguish between a minor sprain and a complex fracture requiring further treatment – without the patient having to make unnecessary trips to obtain a definitive diagnosis.”

High image quality is absolutely essential for fast and reliable “point-of-care diagnostics” directly at the patient’s bedside. However, the mobile, portable X-ray systems currently available on the market for point-of-care applications are limited: Mechanical instabilities in the systems – combined with patient movements associated with breathing, heartbeat, or nervousness – often lead to motion blur in medical imaging, resulting in image artifacts or inaccuracies. “This makes repeated imaging necessary in order to obtain a precise, informative, high-quality X-ray image. In turn, this exposes both the patient and the user to additional radiation,” explains the researcher.

 

Mobile, Compact, Lightweight: A New Level of Technology in X-Ray Diagnostics

The three partners intend to work together to overcome these limitations in the future. By combining their expertise, they aim to develop compact, intelligent sensors that will enable significantly smaller and lighter radiological systems for mobile use while offering maximum image quality.

“Our sensor solution for mobile, portable X-ray systems is unique in that it automatically detects motion caused by tripod instability or handheld components such as X-ray generators or image receptors. An X-ray is only taken once the optimal timing has been determined using our integrated sensors,” says Diana Maier.

To this end, the researchers are developing a new kind of smart sensor module built around MEMS sensors (microelectromechanical systems). These acceleration sensors are used for image stabilization in virtually all of today’s smartphones and tablets. They detect even the slightest movements of the system – such as vibrations or other shocks – with great precision and in real time. By combining and evaluating data from multiple sensor modules installed in the X-ray system, it should subsequently become possible to determine the ideal moment for capturing the image. The system will only be triggered automatically once all parameters for optimal radiological imaging have been determined.

“As this prevents motion artifacts in the X-ray image from the very first image and avoids exposing patients and users to additional radiation from repeat X-rays, the health risks associated with unnecessary X-ray radiation is reduced. This makes mobile X-ray diagnostics much safer for patients,” explains the researcher.

 

Fast and Flexible: Mobile Use Without Limits or Unnecessary Travel

Highly mobile, portable X-ray systems – which are quick and easy to use thanks to the integrated sensors developed by the researchers – do not just offer an alternative for regions with poor infrastructure. They are also an indispensable tool for care facilities with patients who are often immobile or in need of long-term nursing care. “In addition to musculoskeletal injuries, such as fractures or sprains caused by falls, they can also be used, for example, for the rapid initial diagnosis of heart and lung diseases or abdominal conditions – all in the comfort of a familiar environment and without the anxiety or stress of an ambulance ride,“ adds the researcher.

By accompanying emergency medical personnel on their missions, lightweight, portable X-ray solutions with built-in sensor intelligence could also assist them at accident scenes and enhance their ability to respond. “For example, when emergency responders arrive at the site of an accident, they must decide within moments whether a severely injured patient can be moved and is fit for transport. These critical decisions are essential for the patient’s survival and for determining the next steps, especially in the case of severe injuries to the internal organs or spine. Immediate X-ray images could provide the necessary basis for this assessment by the emergency response team. Within seconds, the systems provide a clear X-ray image directly at the scene that supports the diagnosis made by medical professionals – without delay, quickly and reliably,” explains Diana Maier.

By developing compact and lightweight mobile X-ray systems with integrated sensor stabilization, the researchers aim to make these systems easily transportable in the future, including to remote areas and over difficult terrain. “In a backpack-sized format, they can be taken anywhere at any time. Convenient, compact, and ready for use whenever needed, they can reach patients by the most direct route,” says researcher Diana Maier.

The scientists see huge potential for their use in hard-to-reach regions, on alpine terrain, in crisis zones, at mobile medical stations for disaster response, or in humanitarian emergency aid. In addition to human medicine, veterinary medicine also stands to benefit from sensor-assisted mobile X-ray technology in line with the “One Health” concept. Immediate image stabilization allows diagnostic evaluation and treatment decisions to take place directly in the barn or stable, without unnecessarily anesthetizing animals or transporting them over long distances for radiological assessment.

 

At a Glance: Sensor Research in the “DORMO” Project

Research into new smart sensor modules for mobile, portable X-ray systems is being advanced by Fraunhofer ENAS, Klinikum Chemnitz, and Atomed X-Ray GmbH through the two-year “DORMO” project (dose optimization through sensor-controlled X-ray sources for mobile radiology). The project is being co-funded by the European Union and co-financed from tax revenues on the basis of the budget adopted by the Saxon State Parliament.

The project follows on directly from a Memorandum of Understanding (MoU) signed by Fraunhofer ENAS and Klinikum Chemnitz and represents a crucial first step toward realizing the shared vision of close and sustainable links between academia and clinical practice. It sets the stage for closer integration between research, medicine, and medical engineering, and for translating research findings into technological innovations that directly benefit patients.

Together with the “C:HUB Health Cluster Südwestsachsen” initiative and the “Gesundheitscampus Chemnitz” cluster – both of which aim to translate research findings into practical applications more quickly and effectively, this project makes a further significant contribution to strengthening Southwest Saxony and Saxony in the fields of medical engineering and healthcare.