MRI machines for treating soldiers pulled from war zone
By Gregg Zoroya | USA TODAY | Published: January 22, 2014
Advanced brain imaging machines sent to Afghanistan in 2011 at the urging of then-admiral Mike Mullen when he was the Pentagon's top military officer have since been quietly closed down and dismantled.
Mullen hoped the three magnetic resonance imaging or MRI machines would help doctors see on scans the mild traumatic brain injuries that have affected thousands of troops exposed to roadside bombs.
But the senior medical officer for the U.S. Central Command, which oversees military operations in Afghanistan, said it remains unclear whether using MRI machines in the war zone truly helps the process of treating these brain injuries.
Use of them ended last February and they were dismantled for spare parts in October, said Air Force Col. Mark Mavity, Central Command surgeon.
"The device itself doesn't necessarily help you treat that patient. It just helps you understand the nature of the injury in a little bit more meaningful way," Mavity said. "(It) was deemed not worth the cost and investment to keep those devices in theater."
Mullen, former chairman of Joint Chiefs of Staff who retired in 2011, declined through a spokesperson to comment on the machines being dismantled. But he told USA TODAY in a 2011 interview that getting the machines into Afghanistan was "a very high priority."
Mild TBI from blasts is described as an "invisible" wound, diagnosed only through symptoms such as loss of consciousness, dizziness and confusion.
It has left thousands of troops fighting in Iraq and Afghanistan with temporary or, in a few cases, permanent problem-solving and concentration problems.
Mullen made a personal goal of improving the treatment of these wounds. He clashed with military medical officials he thought were moving too slowly to install the MRI machines in the war zone in early 2011.
"I've got kids, I've got young ones, getting blown up," Mullen said in an April 2011 interview. "Tomorrow's not soon enough (for MRI's in Afghanistan)."
The machines were finally in operation by November 2011.
In practice, the machines were viewed by military doctors primarily as tools for conducting a scientific study on their usefulness in the war zone, Mavity said. By November 2012, enough data had been collected from scanning the brains of troops with mild TBI to support that study, he said.
So the need for keeping the machines in operation was in question, Mavity said.
Chris Macedonia, a retired Army colonel who advised Mullen on medical issues, said the machines were intended not just for research but also for ongoing treatment.
"We were upping our game ... we were improving our capabilities in theater," said Macedonia, who said he was unhappy the machines were shut down.
Early findings for the study conducted with the MRI machines show that brain damage was found on imaging scans done on troops exposed to blasts in combat.
Dave Hovda, director of the UCLA Brain Injury Research Center, who also advised Mullen on the issue, said published studies already have established that the MRI helps doctors who are diagnosing and treating mild brain injury.
But Mavity said other factors were behind turning the machines off: the war winding down, the annual $3 million operating cost and the dwindling number of U.S. casualties.
A cost-analysis review also supported the idea, he said.
The final decision in February 2012 to shut down the machines was made by Central Command and Air Force Lt. Gen. Douglass Robb, then medical adviser to the Joint Chiefs of Staff. Robb is now director of the Defense Health Agency overseeing Pentagon medical programs and policies.