Radio frequency electrode system for optical lesion size estimation in functional neurosurgery

Radiofrequency (RF) lesioning in the human brain is one possible surgical therapy for severe pain as well as movement disorders. One obstacle for a safer lesioning procedure is the lack of size monitoring. The aim of this study was to investigate if changes in laser Doppler or intensity signals could be used as markers for size estimation during experimental RF lesioning. A 2 mm in diameter monopolar RF electrode was equipped with optical fibers and connected to a digital laser Doppler system. The optical RF electrode's performance was equal to a standard RF electrode with the same dimensions. An albumin solution with scatterers was used to evaluate the intensity and laser Doppler signal changes during lesioning at 70, 80, and 90 degrees C. Significant signal changes were found for these three different clot sizes, represented by the temperatures (p<0.05, n=10). The volume, width, and length of the created coagulations were correlated to the intensity signal changes (r=0.88, n=30, p<0.0001) and to the perfusion signal changes (r=0.81, n=30, p<0.0001). Both static and Doppler-shifted light can be used to follow the lesioning procedure as well as being used for lesion size estimation during experimental RF lesioning.