Method and apparatus for optimizing transducer array mounting

Abstract

A method for optimizing the placement of a transducer array on a patient includes determining a region of interest within a 3D model of a portion of a subject's body; determining a plane that intersects the portion of the subject's body, the plane including a plurality of pairs of locations along a contour of the plane; adjusting the locations of one or more of the plurality of pairs based on anatomical constraints to generate a modified plane; determining a simulated electric field distribution for each pair of locations; determining a dose metric for each pair based on the simulated electric field distribution; determining one or more sets of pairs that satisfy angular constraints; and determining one or more candidate transducer array layout maps based on the one or more sets of pairs of locations that satisfy the dose metric and angular constraints.

Description

Technical Field

[0001] Cross - Reference to Related Applications This application claims the benefit of priority of U.S. Provisional Application No. 62 / 942,595, filed on December 2, 2019, which is hereby incorporated by reference in its entirety.

Background Art

[0002] Tumor Treating Fields, or TTFields, are low - intensity (e.g., 1 - 3 V / cm) alternating electric fields within the intermediate frequency range (100 - 300 kHz). This non - invasive treatment targets solid tumors and is described in U.S. Patent No. 7,565,205, which is hereby incorporated by reference in its entirety. TTFields inhibit cell division through physical interaction with key molecules during mitosis. TTFields therapy is an approved monotherapy for recurrent glioblastoma and an approved combination therapy with chemotherapy for newly diagnosed patients. These electric fields are non - invasively induced by a transducer array (i.e., an array of electrodes) placed directly on the patient's scalp. TTFields also appear to be beneficial for treating tumors in other parts of the body.

Prior Art Documents

Patent Documents

[0003]

Patent Document 1

Patent Document 2

Non - Patent Documents

[0004]

Non - Patent Document 1

[0005] The described method includes determining a region of interest (ROI) in a 3D model of a portion of the subject's body, determining a plane that crosses the portion of the subject's body based on the center of the ROI, wherein the plane includes multiple pairs of positions along the contour of the plane, generating a modified plane by adjusting one or more positions from the multiple pairs of positions based on anatomical constraints, determining a simulated electric field distribution for each pair of positions from the multiple pairs of positions on the modified plane, determining a dose metric for each pair of positions from the multiple pairs of positions based on the simulated electric field distribution, determining one or more sets of positions from the multiple pairs of positions that satisfy the angular constraint conditions between pairs of transducer arrays, and determining one or more candidate transducer array layout maps based on the dose metric and the one or more sets of positions that satisfy the angular constraint conditions.

[0006] The described method also includes determining a three-dimensional (3D) model of a portion of the subject's body; determining a region of interest (ROI) within the 3D model of the portion of the subject's body; determining an electric field distribution map for each of several positions relative to a pair of transducer arrays, based on the 3D model, ROI, and anatomical constraint parameters; determining several dose metrics within the ROI for each of several combinations of two pairs of transducer arrays, based on the electric field distribution map; determining one or more candidate transducer array layout plans based on angular constraint parameters and several dose metrics within the ROI; determining one or more adjusted candidate transducer array layout plans for each of the one or more candidate transducer array layout plans by adjusting the position or orientation of one or more transducer arrays in a pair of transducer arrays; determining adjusted dose metrics within the ROI for each adjusted candidate transducer array layout plan; and determining a final transducer array layout plan from the adjusted candidate transducer array layout plans based on the adjusted dose metrics within the ROI.

[0007] Additional advantages may be described in part in the following description or may be known in practice. These advantages are realized and achieved using the elements and combinations specifically indicated in the accompanying claims. It should be understood that both the general description above and the detailed description below are illustrative, explanatory, and not restrictive.

[0008] To facilitate the identification of a description of a particular element or activity, one or more of the most significant digits of the reference number indicate the figure number in which that element was first introduced. [Brief explanation of the drawing]

[0009] [Figure 1] This is a diagram illustrating an exemplary apparatus for electrotherapy treatment. [Figure 2]This is a diagram illustrating an exemplary transducer array. [Figure 3A] This diagram illustrates an example of an application of a device for electrotherapy treatment. [Figure 3B] This diagram illustrates an example of an application of a device for electrotherapy treatment. [Figure 4A] This figure shows a transducer array placed on the patient's head. [Figure 4B] This figure shows a transducer array placed on the patient's abdomen. [Figure 5A] This figure shows a transducer array placed on the patient's torso. [Figure 5B] This figure shows a transducer array placed on the patient's pelvic region. [Figure 6] This is a block diagram for electric field generators and patient support systems. [Figure 7] This figure illustrates the electric field magnitude and distribution (in V / cm) shown in the coronal section from a finite element method simulation model. [Figure 8A] This is a diagram showing a three-dimensional array layout map 800. [Figure 8B] This figure shows the placement of the transducer array on the patient's scalp. [Figure 9A] This figure shows an axial T1 sequence slice, including the most apical image, which includes the orbit used to measure head size. [Figure 9B] This figure shows coronal T1 sequence slices selected at the level of the external auditory canal, which is used to measure head size. [Figure 9C] This figure shows a contrast-enhanced T1 axial image indicating the maximal enhancing tumor diameter, which is used to measure the tumor site. [Figure 9D] This figure shows a contrast-enhanced T1 coronal image indicating the maximum-weighted tumor diameter, which is used to measure the tumor site. [Figure 10] A diagram showing an exemplary optimization method. [Figure 11A] A diagram showing an exemplary cross-sectional view based on the center point of a tumor in a patient's head. [Figure 11B] A diagram showing an exemplary cross-sectional view based on the center point of a tumor in a patient's chest. [Figure 12] A diagram showing an exemplary atlas. [Figure 13A] A diagram showing a patient model demonstrating effective and ineffective arrangements (e.g., anatomical limitations) for a transducer array. [Figure 13B] A diagram showing a patient model demonstrating effective and ineffective arrangements (e.g., anatomical limitations) for a transducer array. [Figure 14] A diagram showing the application of anatomical limitations to positions on the contour of a cross-section. [Figure 15] A diagram showing the rotation of a pair of transducer arrays along the contour of a cross-section passing through the head. [Figure 16] A diagram showing the rotation of a pair of transducer arrays along the contour of a cross-section passing through the chest. [Figure 17] A diagram showing the application of angular limitations to positions on the contour of a cross-section. [Figure 18] A diagram showing an exemplary interface. [Figure 19] A block diagram showing an exemplary operating environment. [Figure 20] A diagram showing an exemplary method. [Figure 21] A diagram showing an exemplary method.

Mode for Carrying Out the Invention

[0010] Before the methods and systems of the present invention are disclosed and described, it should be understood that the methods and systems are not limited to any particular method, component, or implementation. It should also be understood that the terms used herein are intended to describe only specific embodiments and are not intended to be limiting.

[0011] As used herein and in the accompanying claims, the singular forms indicated by “one (or sometimes not)” and “it (or sometimes not)” (corresponding to the articles “a,” “an,” and “the” in the original English) include the plural form unless the context clearly indicates otherwise. Ranges may be expressed herein as “approximately” from one particular value and / or “approximately” from the other particular value. When such ranges are expressed, an alternative embodiment includes from one particular value and / or the other particular value. Similarly, when values ​​are expressed as approximations, the use of the antecedent “approximately” will be understood to mean that a particular value forms an alternative embodiment. Furthermore, it will be understood that each endpoint of a range is important both when it relates to other endpoints and when it does not relate to other endpoints.

[0012] "Optional" or "optional" means that the event or situation described thereafter may or may not occur, and that the description includes both cases in which the event or situation occurs and cases in which it does not occur.

[0013] Throughout this description and claims, the words “include,” “equip,” and their conjugations such as “include,” “equip,” and “include,” “equip,” mean “include, but not limited to,” and are not intended to exclude, for example, other components, integers, or steps. “Exemplary” means “an example of,” and is not intended to convey a preference or ideal embodiment. “Etc.” is not used in a restrictive sense and is used for illustrative purposes only.

[0014] Disclosed are components that may be used to carry out the disclosed methods and systems. These and other components are disclosed herein, and while specific references to each of these various individual and collective combinations and permutations may not be expressly disclosed when combinations, subsets, interactions, groups, etc., of these components are disclosed, each is understood to be specifically contemplated and described herein for all methods and systems. This applies to all aspects of this application, including, but not limited to, the steps in the disclosed methods. Thus, where there are various additional steps that may be carried out, each of these additional steps may be carried out in any particular embodiment or combination of embodiments of the disclosed methods.

[0015] The methods and systems of the present invention can be more readily understood by referring to the following detailed description of preferred embodiments and the examples contained herein, as well as the figures and their preceding and succeeding descriptions.

[0016] As will be understood by those skilled in the art, the methods and systems may take the form of embodiments that are entirely hardware, embodiments that are entirely software, or embodiments that combine software and hardware aspects. Furthermore, the methods and systems may take the form of computer program products on a computer-readable storage medium having computer-readable program instructions (e.g., computer software) embodied in the storage medium. More specifically, the methods and systems may take the form of web-implemented computer software. Any suitable computer-readable storage medium may be used, including hard disks, CD-ROMs, optical storage devices, or magnetic storage devices.

[0017] Embodiments of the methods and systems are described below with reference to block diagrams and flowcharts of the methods, systems, apparatus, and computer program products. It will be understood that each block in the block diagrams and flowcharts, as well as combinations of blocks in the block diagrams and flowcharts, can be implemented by computer program instructions. These computer program instructions are loaded onto a general-purpose computer, a dedicated computer, or other programmable data processing device to generate a machine, thereby generating means for instructions executed on the computer or other programmable data processing device to implement the functions specified in one or more flowchart blocks.

[0018] These computer program instructions, which enable a computer (or other programmable data processing device) to function in a particular way, may also be stored in computer-readable memory, thereby producing a product containing computer-readable instructions for implementing a function specified in one or more flowchart blocks, with the instructions stored in computer-readable memory. The computer program instructions may also be loaded into a computer or other programmable data processing device, thereby causing a set of operational steps for generating a computer implementation process to be executed on the computer or other programmable device, and the instructions executed on the computer or other programmable device provide steps for implementing a function specified in one or more flowchart blocks.

[0019] Therefore, the blocks in block diagrams and flowcharts support combinations of means for performing a specified function, combinations of steps for performing a specified function, and program instructions for performing a specified function. It will also be understood that each block in block diagrams and flowcharts, as well as combinations of blocks in block diagrams and flowcharts, may be implemented by a dedicated hardware-based computer system that performs a specified function or step, or a combination of dedicated hardware and computer instructions.

[0020] TTFields, also referred to herein as alternating electric fields, are established as an anti-mitotic carcinoma therapy because they disrupt proper microtubule polymerization during metaphase and ultimately destroy cells during telophase and cytokinesis. Their effectiveness increases with increasing electric field strength, and the optimal frequency depends on the cancer cell line; the frequency at which TTFields inhibit glioma cell growth most effectively was 200 kHz. For cancer treatment, non-invasive devices have been developed, for example, for patients with glioblastoma multiforme (GBM), the most common primary malignant brain tumor in humans, using capacitively coupled transducers that are directly placed in a skin area close to the tumor.

[0021] The effect of TTFields is directional, meaning that cells dividing parallel to the electric field are more affected than cells dividing in other directions. Since cells divide in all directions, TTFields are typically applied through two pairs of transducer arrays that generate an electric field perpendicular to the tumor being treated. More specifically, one pair of transducer arrays may be positioned on the left and right (LR) sides of the tumor, and the other pair on the front and back (AP) sides. Cycling the electric field between these two directions (i.e., LR and AP) ensures that the maximum range of cell orientation is targeted. The other position of the transducer arrays is intended to be beyond the perpendicular electric field. In one embodiment, asymmetric positioning of three transducer arrays is intended, where one pair of the three transducer arrays applies an alternating electric field, then another pair of the three transducer arrays applies an alternating electric field, and the remaining pair of the three transducer arrays applies an alternating electric field.

[0022] In vivo and in vitro studies have shown that the effectiveness of TTFields therapy increases with increasing field intensity. Therefore, optimizing array placement on the patient's scalp to increase intensity in the affected area of ​​the brain is a standard technique of the Optune system. Optimization of array placement can be performed by “rules of thumb” (e.g., placing the array on the scalp as close to the tumor as possible), measurements describing the geometric shape of the patient's head, tumor dimensions, and / or tumor placement. Measurements used as input can be derived from image data. Image data is intended to include any type of visual data, e.g., single-photon emission tomography (SPECT) image data, X-ray computed tomography (X-ray CT) data, magnetic resonance imaging (MRI) data, positron emission tomography (PET) data, data that can be captured by optical instruments (e.g., photographic cameras, charge-coupled device (CCD) cameras, infrared cameras, etc.), and similar. In some implementations, image data may include 3D data acquired from or generated by a 3D scanner (e.g., point cloud data). Optimization can rely on an understanding of how the electric field is distributed within the head as a function of the array's position, and in some embodiments, this may take into account variations in the electrical property distribution within the heads of different patients.

[0023] Figure 1 shows an exemplary apparatus 100 for electrotherapy treatment. Generally, the apparatus 100 may be a portable, battery- or power-operated device that generates an alternating electric field in the body via a non-invasive surface transducer array. The apparatus 100 may comprise an electric field generator 102 and one or more transducer arrays 104. The apparatus 100 may be configured to generate tumor therapeutic electric fields (TTFields) (e.g., 150 kHz) via the electric field generator 102 and to apply the TTFields to a region of the body via one or more transducer arrays 104. The electric field generator 102 may be a battery and / or power-operated device. In one embodiment, one or more transducer arrays 104 have a uniform shape. In one embodiment, one or more transducer arrays 104 do not have a uniform shape.

[0024] The field generator 102 may include a processor 106 that communicates with the signal generator 108. The field generator 102 may also include control software 110 configured to control the execution of the processor 106 and the signal generator 108.

[0025] The signal generator 108 can generate one or more electrical signals in the shape of a waveform or pulse train. The signal generator 108 may be configured to generate AC voltage waveforms with frequencies in the range of about 50 kHz to about 500 kHz (preferably about 100 kHz to about 300 kHz) (e.g., TTFields). These voltages are such that the electric field strength in the tissue to be treated is in the range of about 0.1 V / cm to about 10 V / cm.

[0026] One or more outputs 114 of the electric field generator 102 may be coupled to one or more conductive leads 112, one end of which is attached to the signal generator 108. The other end of the conductive leads 112 is connected to one or more transducer arrays 104 which are activated by an electrical signal (e.g., a waveform). The conductive leads 112 may consist of standard isolated conductors with flexible metal shielding and may be grounded to prevent the spread of the electric field generated in the conductive leads 112. One or more outputs 114 may be operated sequentially. Output parameters of the signal generator 108 may include, for example, the electric field strength, the frequency of the wave (e.g., a therapeutic frequency), and the maximum allowable temperature of the one or more transducer arrays 104. The output parameters may be set and / or determined by control software 110 in conjunction with the processor 106. After determining the desired (for example, optimal) treatment frequency, the control software 110 causes the processor 106 to send a control signal to the signal generator 108, causing the signal generator 108 to output the desired treatment frequency to one or more transducer arrays 104.

[0027] One or more transducer arrays 104 may be configured in various shapes and positions to generate an electric field of a desired configuration, direction, and intensity at the target volume region where treatment is concentrated. One or more transducer arrays 104 may be configured to bring two perpendicular electric field directions through the volume region of interest.

[0028] The array of one or more transducer arrays 104 may comprise one or more electrodes 116. The one or more electrodes 116 may be made of any material having a high dielectric constant. The one or more electrodes 116 may comprise, for example, one or more insulating ceramic discs. The electrodes 116 may be biocompatible and bonded to a flexible circuit board 118. The electrodes 116 may be configured so as not to come into direct contact with the skin, as they are separated from the skin by a layer of conductive hydrogel (not shown) (similar to those found in electrocardiogram pads).

[0029] The electrodes 116, hydrogel, and flexible circuit board 118 may be attached to a hypoallergenic medical bandage 120 to hold one or more transducer arrays 104 in place on the body and in continuous direct contact with the skin. Each transducer array 104 may be equipped with one or more thermistors (not shown), for example, eight thermistors (accuracy ±1°C), to measure the skin temperature beneath the transducer array 104. The thermistors may be configured to measure the skin temperature periodically, for example, every second. The thermistors may be read by control software 110 when TTFields are not applied to avoid interference with the temperature measurement.

[0030] If the measured temperature falls below a preset maximum temperature (Tmax), for example 38.5–40.0°C ± 0.3°C, between two subsequent measurements, the control software 110 may increase the current until it reaches the maximum therapeutic current (for example, 4 amperes peak-to-peak). If the temperature reaches Tmax + 0.3°C and continues to rise, the control software 110 may decrease the current. If the temperature rises to 41°C, the control software 110 may stop the TTFields therapy, and an overheat alarm may be triggered.

[0031] One or more transducer arrays 104 may vary in size and may have varying numbers of electrodes 116 depending on the patient's body size and / or different treatment methods. For example, in the context of the patient's chest, a small transducer array may have 13 electrodes each, and a large transducer array may have 20 electrodes each, with the electrodes interconnected in series within each array. For example, in the context of the patient's head, as shown in Figure 2, each transducer array may have 9 electrodes each, with the electrodes interconnected in series within each array.

[0032] One or more alternative structures for the transducer array 104 may be contemplated and used, including, for example, transducer arrays using non-disk-shaped ceramic elements and transducer arrays using non-ceramic dielectric material positioned on multiple flat conductors. An example of the latter includes a polymer film disposed on pads of a printed circuit board or on a flat metal piece. Transducer arrays using uncoupled electrode elements may also be used. In this scenario, each element of the transducer array is mounted using a region of conductive material configured to rest in contact with the subject / patient's body, and no insulating dielectric layer is disposed between the conductive element and the body. Other alternative structures for mounting the transducer array may also be used. The configuration, arrangement, type, and / or similar of the transducer array (or similar device / component) may be used in the methods and systems described herein, insofar as (a) it can apply TTFields to the body of a subject / patient and (b) it can be positioned, arranged, and / or mounted on a portion of the body of a patient / subject as described herein.

[0033] The status and monitoring parameters of the device 100 may be stored in memory (not shown) and transferred to a computing device via a wired or wireless connection. The device 100 may include a display (not shown) for displaying visual indicators such as power on, treatment on, alarms, and low battery.

[0034] Figures 3A and 3B illustrate application examples of the device 100. Transducer arrays 104a and 104b are shown, incorporated into hypoallergenic medical bandages 120a and 120b, respectively. The hypoallergenic medical bandages 120a and 120b are applied to the skin surface 302. The tumor 304 is located beneath the skin surface 302 and bone tissue 306, and within brain tissue 308. The field generator 102 causes transducer arrays 104a and 104b to generate an alternating electric field 310 within the brain tissue 308, disrupting the rapid cell division presented by the cancer cells of the tumor 304. The alternating electric field 310 has been shown in nonclinical experiments to halt the proliferation of tumor cells and / or destroy them. The use of alternating electric field 310 takes advantage of the specific properties, geometric shape, and division rate of cancer cells that make them susceptible to the effects of alternating electric field 310. Alternating electric field 310 changes its polarity at intermediate frequencies (on the order of 100–300 kHz). The frequency used for a particular treatment may be specific to the type of cell being treated (e.g., 150 kHz for MPM). Alternating electric field 310 has been shown to disrupt spindle microtubule polymers, leading to dielectrophoretic transposition of intracellular macromolecules and organelles during cytokinesis. These processes result in physical disruption of the cell membrane and programmed cell death (apoptosis).

[0035] The effect of the alternating electric field 310 is directional, meaning that cells dividing parallel to the electric field are more affected than cells dividing in other directions. Since cells divide in all directions, the alternating electric field 310 can be applied through two pairs of transducer arrays 104 that generate an electric field perpendicular to the tumor being treated. More specifically, one pair of transducer arrays 104 may be positioned on the left and right (LR) sides of the tumor, and the other pair of transducer arrays 104 may be positioned on the front and back (AP) sides of the tumor. Cycling the alternating electric field between these two directions (e.g., LR and AP) ensures that the widest range of cell orientations is targeted. In one embodiment, the alternating electric field 310 can be applied according to a symmetrical setup of transducer arrays 104 (e.g., four transducer arrays 104 in total, two matched pairs). In another embodiment, the alternating electric field 310 can be applied according to an asymmetrical setup of transducer arrays 104 (e.g., three transducer arrays 104 in total). An asymmetric setup of the transducer array 104 allows for engaging two of the three transducer arrays 104 to apply the alternating electric field 310, then switching to the other two of the three transducer arrays 104 to apply the alternating electric field 310, and so on.

[0036] In vivo and in vitro studies have shown that the effectiveness of TTFields therapy increases with increasing field intensity. The methods, systems, and apparatus described are configured to optimize array placement on the patient's scalp to increase intensity in the affected area of ​​the brain.

[0037] As shown in Figure 4A, the transducer array 104 may be placed on the patient's head. As shown in Figure 4B, the transducer array 104 may be placed on the patient's abdomen. As shown in Figure 5A, the transducer array 104 may be placed on the patient's torso. As shown in Figure 5B, the transducer array 104 may be placed on the patient's pelvis. Placement of the transducer array 104 on other parts of the patient's body (e.g., arms, legs, etc.) is particularly intended.

[0038] Figure 6 is a block diagram showing a non-limiting example of system 600 including a patient support system 602. The patient support system 602 may comprise one or more computers configured to operate and / or store an EFG (Field Generator) configuration application 606, a patient modeling application 608, and / or image data 610. The patient support system 602 may comprise, for example, a computing device. The patient support system 602 may include, for example, a laptop computer, a desktop computer, a mobile phone (e.g., a smartphone), a tablet, and the like.

[0039] The patient modeling application 608 may be configured to generate a three-dimensional model (e.g., a patient model) of a portion of the patient's body according to image data 610. The image data 610 may include any type of visual data, such as single-photon emission tomography (SPECT) image data, X-ray computed tomography (X-ray CT) data, magnetic resonance imaging (MRI) data, positron emission tomography (PET) data, data that can be captured by optical instruments (e.g., photographic cameras, charge-coupled device (CCD) cameras, infrared cameras, etc.), and similar. In some implementations, the image data may also include 3D data (e.g., point cloud data) acquired from or generated by a 3D scanner. The patient modeling application 608 may also be configured to generate a three-dimensional array layout map based on the patient model and one or more electric field simulations.

[0040] To appropriately optimize array placement on a portion of a patient's body, image data 610, such as MRI image data, can be analyzed by a patient modeling application 608 to identify regions of interest, including tumors. In the context of a patient's head, a modeling framework based on an anatomical head model using finite element method (FEM) simulations can be used to characterize how electric fields behave and distribute within the human head. These simulations generate a realistic head model based on magnetic resonance imaging (MRI) measurements, separating tissue types within the head, such as the skull, white matter, gray matter, and cerebrospinal fluid (CSF). Each tissue type is assigned dielectric properties in terms of relative conductivity and relative permittivity, and simulations are often performed in which different transducer array configurations are applied to the surface of the model, thereby understanding how an externally applied electric field of a preset frequency is distributed throughout any part of the patient's body, e.g., the entire brain. Results from these simulations employing paired array configurations, constant current, and a preset frequency of 200 kHz demonstrate that the electric field distribution is relatively non-uniform throughout the brain, and that electric field strengths exceeding 1 V / cm occur in most tissue compartments except the CSF. These results are obtained assuming a total current with a peak-to-peak value of 1800 milliamperes (mA) at the transducer array interface with the scalp. This threshold of electric field strength is sufficient to halt cell proliferation in glioblastoma cell lines. In addition, by manipulating the configuration of the paired transducer arrays, it is possible to achieve nearly three times the electric field strength for specific regions of the brain, as shown in Figure 7. Figure 7 illustrates the electric field magnitude and distribution (in V / cm) shown in coronal sections from a finite element method simulation model. This simulation employs a left-right paired transducer array configuration.

[0041] In one embodiment, the patient modeling application 608 may be configured to determine a desired (e.g., optimal) transducer array layout for the patient based on the location and extent of the tumor. For example, initial morphometric head size measurements may be determined from a T1 sequence of brain MRI using axial and coronal images. Post-contrast axial and coronal MRI slices may be selected to show the maximum diameter of the emphasized lesion. By employing measurements of head size and distance from a predetermined reference marker to the tumor margin, various permutations and combinations of paired array layouts may be evaluated to generate a configuration that applies the maximum electric field intensity to the tumor site. As shown in Figure 8A, the output may be a three-dimensional array layout map 800. The three-dimensional array layout map 800 may be used by the patient and / or caregiver when positioning and configuring the array on the scalp during the normal course of TTFields therapy, as shown in Figure 8B.

[0042] In one embodiment, the patient modeling application 608 may be configured to determine a three-dimensional array layout map for the patient. MRI measurements of the parts of the patient that are to receive the transducer array may be determined. For example, the MRI measurements may be received via a standard Digital Imaging and Communications in Medicine (DICOM) viewer. The MRI measurement determination may be performed, for example, automatically, using artificial intelligence technology, or manually, for example, by a physician.

[0043] Manual MRI measurement decisions may include receiving and / or providing MRI data via a DICOM viewer. MRI data may include scans of a portion of the patient containing a tumor. For example, in the context of a patient's head, MRI data may include scans of the head containing one or more of the following: a right frontotemporal tumor, a right parietal-temporal tumor, a left frontotemporal tumor, a left parietal-occipital tumor, and / or a multifocal midline tumor. Figures 9A, 9B, 9C, and 9D illustrate examples of MRI data showing scans of a patient's head. Figure 9A shows an axial T1 sequence slice including a apical image, including the orbit, used to measure head size. Figure 9B shows a coronal T1 sequence slice with an image selected at the level of the external auditory canal, used to measure head size. Figure 9C shows a post-contrast T1 axial image showing the maximum-weighted tumor diameter, used to measure tumor site. Figure 9D shows a post-contrast T1 coronal image showing the maximum-weighted tumor diameter, used to measure tumor site. MRI measurements may begin at a reference marker on the outer edge of the scalp and extend tangentially from the right, anterior, and superior origins. Morphometric head size can be estimated from an axial T1 MRI sequence, selecting the apex image (or image directly above the upper edge of the orbit) that still included the orbit.

[0044] In one embodiment, the MRI measurements may include, for example, one or more of head size measurements and / or tumor measurements. In one embodiment, one or more MRI measurements may be rounded to the nearest millimeter value and provided to a transducer array mounting module (e.g., software) for analysis. The MRI measurements may then be used to generate a three-dimensional array layout map (e.g., three-dimensional array layout map 800).

[0045] MRI measurements may include one or more head size measurements, such as the maximum anterior-posterior (AP) head size, starting from the outer edge of the scalp; the maximum head width perpendicular to the AP measurement; the lateral distance from right to left; and / or the distance from the rightmost edge of the scalp to the anatomical midline.

[0046] MRI measurements may include one or more head size measurements, such as coronal head size measurements. Coronal head size measurements can be obtained in a T1 MRI sequence that selects images at the level of the external auditory canal (Figure 9B). Coronal head size measurements may include one or more of the following: vertical measurement from the apex of the scalp to a line perpendicular to the lower edge of the temporal lobe, maximum left-right temporal width, and / or distance from the right edge of the scalp to the anatomical midline.

[0047] MRI measurements may include one or more tumor measurements, such as tumor location measurements. Tumor location measurements may be performed first on an axial image showing the maximum-weighted tumor diameter (Figure 9C) using a T1 contrast-enhanced MRI sequence. Tumor location measurements may include one or more of the following: maximum AP head size excluding the nose, maximum lateral diameter measured perpendicular to the AP distance, distance from the right edge of the scalp to the anatomical midline, distance from the right edge of the scalp to the nearest tumor edge measured parallel to the lateral lateral distance and perpendicular to the AP measurement, distance from the right edge of the scalp to the furthest tumor edge measured parallel to the lateral lateral distance and perpendicular to the AP measurement, distance from the frontal region to the nearest tumor edge measured parallel to the AP measurement, and / or distance from the frontal region to the furthest tumor edge measured parallel to the AP measurement.

[0048] One or more tumor measurements may include coronal tumor measurements. Coronal tumor measurements may include identifying a contrast-enhanced T1 MRI slice characterized by the maximum diameter of the tumor (Figure 9D). Coronal tumor measurements may include one or more of the maximum distances from the apex of the scalp to the lower edge of the cerebrum. In anterior slices, this is demarcated by a horizontal line drawn at the lower edge of the frontal or temporal lobe, and posteriorly, it extends to the lowest level of the visible tentorium, the maximum left-right lateral head width, the distance from the right edge of the scalp to the anatomical midline, the distance from the right edge of the scalp to the nearest tumor edge measured parallel to the right-left transverse distance, the distance from the right edge of the scalp to the furthest tumor edge measured parallel to the right-left transverse distance, the distance from the vertex to the nearest tumor edge measured parallel to the inferior cerebral line, and / or the distance from the vertex to the furthest tumor edge measured parallel to the inferior cerebral line.

[0049] Other MRI measurements may be used, especially when the tumor is located in a different part of the patient's body.

[0050] MRI measurements may be used by patient modeling application 608 to generate a patient model. The patient model may then be used to determine a three-dimensional array layout map (e.g., three-dimensional array layout map 800). Continuing with the example of a tumor in the patient's head, a healthy head model may be generated that serves as a deformable template from which the patient model can be created. When creating the patient model, the tumor may be segmented from the patient's MRI data (e.g., one or more MRI measurements). Segmenting the MRI data allows for the identification of tissue types within each voxel, and based on empirical data, electrical properties may be assigned to each tissue type. Table 1 shows standard electrical properties of tissues that may be used in the simulation. The tumor region in the patient MRI data is masked, and a non-rigid registration algorithm may be used to align the remaining region of the patient's head onto a 3D discrete image representing a deformable template of the healthy head model. This process produces a non-rigid transformation that maps the healthy portion of the patient's head into template space, and further, an inverse transformation that maps the template into patient space. This inverse transformation is applied to the 3D deformable template to generate an approximation of the patient's head as it would be without the tumor. Finally, the tumor (referred to as a region of interest (ROI)) is implanted back into the modified template to generate a complete patient model. The patient model may be a digital representation in three-dimensional space of parts of the patient's body, including internal structures such as tissues, organs, and tumors. [Table 1]

[0051] Next, the application of TTFields can be simulated by a patient modeling application 608 using a patient model. In one embodiment, the patient modeling application 608 may be configured to perform method 1000, as shown in Figure 10. Method 1000 can efficiently identify the optimal transducer array layout for applying a high dose (electric field) to a region of interest (ROI) (e.g., a tumor). Method 1000 may include determining a cross-section through the ROI in step 1010. A reference coordinate system may be defined to ensure the systematic positioning of the transducer array with respect to the ROI (e.g., tumor placement). As shown in Figure 11A, the cross-section 1102 may first be defined by the center and tilt angle of the region of interest 1104. The tilt angle may be defined by those skilled in the art. For example, the tilt angle relative to the head may be 150-20 degrees off from the axial plane (e.g., horizontal). The cross section 1102 may include a contour created by the boundaries (e.g., outline) of an anatomical model (e.g., head, chest, torso, abdomen, legs, arms, and similar). For example, the contour may resemble an ellipse, a circle, an irregular shape, and similar shapes. Determining the cross section 1102 may include determining a plurality of locations 1106 along the contour of the cross section 1102. The plurality of locations 1106 may represent arrangements in which the transducer array can be attached to a patient. The plurality of locations 1106 may be determined such that the electric field generated by the transducer array at each location passes through the ROI 1104. Any number of locations 1106 are intended. In one embodiment, the locations 1106 may be divided into pairs such that the alternating electric fields generated by pairs of transducer arrays (each transducer array is placed in one of the pairs of locations) pass through the ROI 1104. Position 1106 may be spaced, for example, by 15 degrees, corresponding to a translation of approximately 2 cm, which gives a total of 12 different positions within a 180-degree range. Other spacings are also conceivable.

[0052] Figure 11A shows a definition of a cross-section 1102 in the patient's head, and Figure 11B shows a cross-section 1102 as defined in the patient's chest. A cross-section 1102 can be defined in any part of the patient's body.

[0053] Referring again to Figure 10, after determining the cross section 1102 through ROI 1104 and multiple locations 1106 in step 1010, method 1000 may apply an anatomical restriction to location 1106 in step 1020. The anatomical restriction may be determined based on a patient model and / or by observation. The anatomical restriction may be associated with the patient's anatomical features, such as the eyes, ears, joints, armpits, nipples, and genitals. The anatomical restriction may be associated with areas of the patient that should be avoided for transducer array implantation because they may cause discomfort or pain to the patient, such as areas with irritation, wounds, scars, and similar conditions.

[0054] The application of anatomical restrictions ensures that only anatomically valid placements are considered for transducer array placement. The patient modeling application 608 may be configured to determine anatomical restrictions. In one embodiment, anatomical restrictions may be determined by generating an atlas containing partial patient image data (e.g., head MRI data) and a binary image. The binary image may be manually created by a specialist segmenting the valid portion of the image data. Figure 12 shows an exemplary atlas created by combining a head MRI image and a binary image. A specialist manually segments the valid zone 1202 on the atlas MRI, and the valid zone 1202 is saved as a binary image. For example, the valid zone 1202 may be associated with "1" in the binary image. In one embodiment, the same binary image may be used for multiple patients. In another embodiment, a binary image may be generated for each patient.

[0055] Given a patient model for a new patient, a transformation is calculated to align the atlas to the patient model and applied to the binary image to mask the effective zone. The binary image can then be modified to fit the patient model boundaries. Figures 13A and 13B show a patient model with an effective surface (green) shown on the patient's head surface (gray). From the patient model, two effective surfaces can be determined for the surface relative to the vertical layout and the surface relative to the horizontal layout. The surface may include points and triangles. Each point within the green area may represent an anatomically valid position for transducer array placement, while the gray area represents an anatomical constraint.

[0056] In one embodiment, an anatomical restriction may define one or more locations 1106 of the cross section 1102 that should be excluded from use in determining the electric field distribution. In one embodiment, an anatomical restriction may define one or more locations 1106 of the cross section 1102 that should be moved (e.g., raised, lowered, shifted, and similar actions) to take the anatomical restriction into account. As shown in Figure 14, location 1106B may be raised to avoid the anatomical restriction 1402 (ear), which adjusts the contour of the cross section 1102 to a 3D curved contour. As a result of placing the transducer array on location 1106C, the transducer array will be placed on the anatomical restriction 1404 (scar), and therefore location 1106C may be excluded from further analysis.

[0057] Referring again to Figure 10, after applying the anatomical constraints in step 1020, method 1000 can determine the simulated electric field distribution for a pair of transducer arrays at position 1106 in the cross section 1102. In one embodiment, as shown in Figure 15, transducer arrays 120A, 120B (not shown to scale) may be virtually placed such that their centers and longitudinal axes along opposing positions 1106 are defined along the edges of the cross section 1102, and the cross section 1102 passes through the patient's head. Opposing positions 1106 include positions placed along a centerline intersecting ROI 1104. As shown in Figure 15, opposing positions include 1106A:1106F, 1106B:1106G, 1106D:1106H, and 1106E:1106I. The centerline is indicated by a dashed line connecting the opposing positions 1106. The centerline may represent the path of the electric field 1108 generated by either transducer array at either of the opposing positions 1106. Figure 16 shows that transducer arrays 120A and 120B (not shown to scale) may be virtually placed with their centers and longitudinal axes along opposing positions 1106 defined along the edges of a cross section 1102, which passes through the patient's torso.

[0058] Referring again to Figure 15, in one embodiment, the pair of transducer arrays 120A and 120B may first be placed in any opposing position 1106 and rotated around the cross section 1102 within a range of 0 to 180 degrees to each pair of opposing positions 1106, thereby covering the entire circumference of the cross section 1102. For example, the pair of transducer arrays 120A and 120B may be virtually placed at opposing positions 1106A:1106F, and a simulated electric field distribution may be determined; the pair of transducer arrays 120A and 120B may be rotated around the cross section 1102 to opposing positions 1106B:1106G, and a simulated electric field distribution may be determined; the pair of transducer arrays 120A and 120B may be rotated around the cross section 1102 to opposing positions 1106D:1106H, and a simulated electric field distribution may be determined; the pair of transducer arrays 120A and 120B may be rotated around the cross section 1102 to opposing positions 1106E:1106I, and a final simulated electric field distribution may be determined. As shown in Table 2, a TTFields distribution map containing the simulated electric field distribution for each pair of positions may be generated. [Table 2]

[0059] Referring again to Figure 10, after the simulated electric field distribution is determined in step 1030, method 1000 may proceed to step 1040 to determine a dose metric for each of the multiple pairs of transducer arrays. In one embodiment, method 1000 may determine a dose metric based on the electric field distribution determined for each of the two pairs of transducer arrays 120. The simulated electric field distribution, dosimetry, and simulation-based analysis are described in U.S. Patent Application Publication No. 20190117956 and publication “Correlation of Tumor Treating Fields Dosimetry to Survival Outcomes in Newly Diagnosed Glioblastoma: A Large-Scale Numerical Simulation-based Analysis of Data from the Phase 3 EF-14 randomized Trial” (2019) by Ballo et al., which are incorporated in whole herein by reference. The dose metric at ROI may be determined for all possible position 1106 combinations of the two pairs of transducer arrays 120. Table 3 shows the results of determining the dose metric in step 1040. [Table 3]

[0060] After the dose metric is determined in step 1040, method 1000 may proceed to step 1050 and apply angular constraints to multiple pairs of transducer arrays. In one embodiment, method 1000 may determine one or more candidate transducer array layout plans according to the angular constraints in step 1050. The angular constraints may represent constraints on the position of a transducer array relative to other transducer arrays. The angular constraints may be determined based on the desired number of pairs of transducer arrays. In one embodiment, the angular constraints may be determined by dividing 180 degrees by the desired number of pairs of transducer arrays. For example, if two pairs of transducer arrays are desired, the angular constraint may be about 90 degrees. In one embodiment where three pairs of transducer arrays are desired, the angular constraint may be about 60 degrees. In one embodiment where four pairs of transducer arrays are desired, the angular constraint may be about 45 degrees. An angular limit may specify that the transducer array pair should be positioned such that the angular limit is satisfied for at least one other transducer array pair. The angular limit may be evaluated based on the centerlines between the positions 1106 where the transducer array pair is positioned.

[0061] The angle limit may exclude from consideration transducer array positions that would cause the transducer array position to fall within or outside the angle limit. For example, the angle limit may indicate that only transducer array positions that form an orthogonal (90-degree) angle between two pairs of transducer arrays are considered. Any angle may be contemplated in the angle limit. The angle limit may further include a range, which may be, for example, between 30 and 90 degrees. In one embodiment, the size of the transducer array may affect the angle limit. The smaller the transducer array, the more transducer arrays may be used. Therefore, the angle limit may be relatively small (e.g., 30 to 45 degrees) to account for the increasing number of smaller transducer arrays.

[0062] In step 1050, method 1000 can determine the angle between each combination of two pairs of transducer arrays 120. As shown in Figure 17, the transducer array pair located at positions 1106A:1106F is associated with a centerline (dashed line) that forms a 90-degree angle with respect to the centerline associated with another transducer array pair located at positions 1106D:1106H. The transducer array pair located at positions 1106A:1106F is associated with a centerline (dashed line) that forms a 30-degree angle with respect to the centerline associated with another transducer array pair located at positions 1106B:1106G. Table 4 shows the results of determining the dose metrics and angles for the position combinations of the transducer array pairs 120 shown in Figure 17. [Table 4]

[0063] Referring again to Figure 10, in step 1050, one or more candidate transducer array layout plans may be determined by filtering out transducer array pair positions that deviate from the angular limits. For example, in Table 4, a candidate transducer array layout plan may include positions (1106A:1106F) and (1106D:1106H). Another candidate transducer array layout plan may include positions (1106B:1106G) and (1106E:1106I) of position 1106. In one embodiment, candidate transducer array layout plans that deviate from the angular limits may be selected to allow the user to examine the effect of different transducer array layout plans on dose density maps and dose metrics.

[0064] After the angle limit is applied in step 1050, method 1000 may proceed to step 1060 to determine the overlap between transducer arrays. Since the electric field distribution performed in step 1030 was calculated for individual transducer array pairs, the position and orientation of the transducer arrays 120 in each candidate transducer array layout plan view may result in physical overlap between adjacent transducer arrays 120. Overlap between adjacent transducer arrays 120 may be formed as a result of any part of one transducer array 120 overlapping with any part of another transducer array 120. For example, the transducer arrays 120 may include adhesive bandages designed to keep the transducer arrays 120 attached to the patient during treatment. In step 1050, method 1000 may determine that there is a possibility that the bandage of one transducer array 120 may overlap with a portion of another transducer array 120 (for example, it may overlap with another bandage, a conductive lead 112, and / or an electrode 116). In another example, in step 1050, method 1000 may determine that one or more electrodes 116 of transducer array 120 overlap with a portion of another transducer array 120 (for example, it overlaps with another bandage, a conductive lead 112, and / or an electrode 116). In one embodiment, some overlaps, such as overlapping bandages, may be ignored. In one embodiment, some overlaps, such as overlapping electrodes 116, may not be ignored. The patient modeling application 608 may be configured to determine, based on predetermined size information associated with each transducer array, whether there is overlap between transducer arrays and whether such overlap justifies adjustment of the transducer arrays (e.g., overlapping electrodes versus overlapping bandages).

[0065] In one embodiment, in step 1060, method 1000 may cause the transducer arrays 120 to be reoriented and / or positioned to eliminate (or reduce) overlap between them for each candidate transducer array layout plan view. In one embodiment, in step 1070, method 1000 may present one or more of a plurality of pairs of transducer arrays. The patient modeling application 608 may be configured to present one or more candidate transducer array layout plan views and / or one or more adjusted candidate transducer array layout plan views. In one embodiment, the patient modeling application 608 may present one or more candidate transducer array layout plan views and / or one or more adjusted candidate transducer array layout plan views for selection as the final transducer array layout plan view and / or for further adjustment by the user. The final transducer array layout plan view may be determined from the candidate transducer array layout plan views and / or adjusted candidate transducer array layout plan views based on the electric field distribution and / or dose metric.

[0066] In one embodiment shown in Figure 18, a plan view of one or more candidate transducer array layouts may be displayed to the user. The user may manipulate the placement of each transducer array, and changes in the resulting electric field distribution and dose metrics may be displayed.

[0067] Regarding the optimization method, the electric field distribution described above can be determined by patient modeling application 608 using the finite element (FE) approximation of the potential. In general, the quantities that define the time-varying electromagnetic field are given by the complex Maxwell equations. However, within biological tissue, at low to intermediate frequencies (f=200kHz) of TTFields, the wavelength of electromagnetic waves is considerably larger than the size of the head, and the dielectric constant ε is negligibly small compared to the real-value electrical conductivity σ, i.e., ω=2πf is the angular frequency. This means that the electromagnetic wave propagation and capacitance effects within the tissue are negligibly small, and therefore the scalar potential can be well approximated by the static Laplace equation ∇·(σ∇φ)=0 under appropriate boundary conditions at the electrodes and skin. Thus, the complex impedance is treated as resistive (i.e., reactance is negligible), and therefore the current flowing through a volumetric conductor is mainly free (ohmic) current. The FE approximation of the Laplace equation was calculated using SimNIBS software (simnibs.org). The calculations were based on the Galerkin method, requiring that the residual of the conjugate gradient solver be <1E-9. Dirichlet boundary conditions were used, and the potentials were set to (arbitrarily selected) fixed values ​​for each set of electrode arrays. The electric field (vector field) was calculated as the numerical gradient of the potential, and the current density (vector field) was calculated from the electric field using Ohm's law. The potential difference and current density of the electric field values ​​were linearly rescaled so that the peak-to-peak total amplitude for each array pair was 1.8A, and calculated as the (numerical) surface integral of the normal current density component across all triangular surface elements on the active electrode disk. This corresponds to the current levels used in clinical TTFields therapy with the Optune® device. The "dose" of TTFields was calculated as the intensity (L2 norm) of the electric field vector. The modeled current is assumed to be supplied by two separate, sequentially activated sources, each connected to a pair of 3x3 transducer arrays. In the simulation, the left and rear arrays were defined as sources, and the right and front arrays were defined as corresponding sinks. However, since TTFields employs alternating electric fields, this choice was made. This is optional and does not affect the outcome.

[0068] The average intensity of the electric field generated by transducer arrays placed in multiple positions on a patient can be determined by the patient modeling application 608 for one or more tissue types. In one embodiment, the transducer array position corresponding to the highest average electric field intensity in a tumor tissue type can be selected as the desired (e.g., optimal) transducer array position for the patient. Thus, the transducer array position corresponding to the highest average electric field intensity in a tumor tissue type can be selected as the desired (e.g., optimal) transducer array layout map for the patient. In one embodiment, method 1000 may be used to determine the transducer array layout map.

[0069] The patient model may be modified to include instructions for a desired transducer array layout map. The resulting patient model, including instructions for a transducer array layout map, may be referred to as a three-dimensional array layout map (e.g., three-dimensional array layout map 600). Thus, the three-dimensional array layout map may include a digital representation in three-dimensional space of a portion of the patient's body, instructions for tumor placement, instructions for the placement of one or more transducer arrays, combinations thereof, and so on.

[0070] The three-dimensional array layout map may be provided to the patient in digital and / or physical form. The patient, and / or the patient's caregiver, may use the three-dimensional array layout map to attach one or more transducer arrays to the relevant parts of the patient's body (e.g., the head).

[0071] The three-dimensional array layout map may further include indications of one or more landmarks on parts of the patient's body (e.g., curves, protrusions, creases, structures (e.g., ears, nose, nipples, etc.)). The indications of one or more landmarks on parts of the patient's body may be derived from image data by the patient modeling application 608. The three-dimensional array layout map may include positional data indicating the placement of one or more transducer arrays on parts of the body, and surface data indicating one or more landmarks on parts of the body. Digital three-dimensional representations may be used as described in Bucking TM et al. (2017), From medical imaging data to 3D printed anatomical models, PLoS ONE 12(5): e0178540, and Ahmed Hosny et al., J Thorac Cardiovasc Surg 2018, 155:143-145, which are incorporated herein by reference.

[0072] Figure 19 is a block diagram illustrating an environment 1900 including a non-limiting example of the patient support system 104. In one embodiment, some or all steps of any described method may be performed on a computing device such as those described herein. The patient support system 104 may comprise one or more computers configured to store one or more of the EFG configuration application 606, the patient modeling application 608, image data 610, and the like.

[0073] The patient support system 104 may, in terms of hardware architecture, be a digital computer generally comprising a processor 1908, a memory system 1910, an input / output (I / O) interface 1912, and a network interface 1914. These components (1908, 1910, 1912, and 1914) are communicatively coupled via a local interface 1916. The local interface 1916 may be, for example, one or more buses or other wired or wireless connections, as are known in the art, but are not limited to. The local interface 1916 may have additional elements, omitted for simplification, such as controllers, buffers (caches), drivers, repeaters, and receivers, to enable communication. Furthermore, the local interface may include address, control, and / or data connections to enable proper communication between the aforementioned components.

[0074] The processor 1908 can be a hardware device for executing software, particularly software stored in the memory system 1910. The processor 1908 can be any custom-made or commercially available processor, a central processing unit (CPU), an auxiliary processor among several processors associated with the patient support system 104, a semiconductor-based microprocessor (in the form of a microchip or chipset), or any device in general for executing software instructions. When the patient support system 104 is operating, the processor 1908 may be configured to execute software stored in the memory system 1910, communicate data with the memory system 1910, and generally control the operation of the patient support system 104 according to the software.

[0075] The I / O interface 1912 may be used to receive user input from one or more devices or components and / or provide system output. User input may be provided, for example, via a keyboard and / or mouse. System output may be provided via a display device and / or printer (not shown). The I / O interface 1912 may include, for example, a serial port, a parallel port, a Small Computer System Interface (SCSI), an IR interface, an RF interface, and / or a Universal Serial Bus (USB) interface.

[0076] The network interface 1914 may be used for transmission and reception from the patient support system 104. The network interface 1914 may include, for example, a 10BaseT Ethernet adapter, a 100BaseT Ethernet adapter, a LAN PHY Ethernet adapter, a Token Ring adapter, a wireless network adapter (e.g., WiFi), or any other suitable network interface device. The network interface 1914 may include address, control, and / or data connections to enable appropriate communication.

[0077] The memory system 1910 may include any one or a combination of volatile memory elements (e.g., random access memory (RAM such as DRAM, SRAM, SDRAM, etc.)) and non-volatile memory elements (e.g., ROM, hard drives, tapes, CD-ROMs, DVD-ROMs, etc.). Furthermore, the memory system 1910 may incorporate electronic, magnetic, optical, and / or other types of storage media. It should be noted that the memory system 1910 may have a distributed architecture in which various components are located geographically separated from each other but can be accessed by the processor 1908.

[0078] The software in the memory system 1910 may include one or more software programs, each containing an ordered listing of executable instructions for implementing a logical function. In the example in Figure 19, the software in the memory system 1910 of the patient support system 104 may include an EFG configuration application 606, a patient modeling application 608, image data 610, and a preferred operating system (O / S) 1918. The operating system 1918 essentially controls the execution of other computer programs and provides scheduling, input / output control, file and data management, memory management, and communication control and related services.

[0079] For illustrative purposes, application programs and other executable program components, such as the operating system 1918, are illustrated herein as separate blocks, but it is understood that such programs and components may be placed in different storage components of the patient support system 104 at different points in time. One implementation of the EFG configuration application 606, the patient modeling application 608, the image data 610, and / or the control software 110 may be stored in or transmitted through some form of computer-readable medium. Any of the disclosed methods may be executed by computer-readable instructions embodied on the computer-readable medium. The computer-readable medium may be any available medium that can be accessed by a computer. For example, but not limited to, the computer-readable medium may include “computer storage medium” and “communication medium.” The “computer storage medium” may include volatile and non-volatile, removable and non-removable media implemented in any way or technique for storing information, such as computer-readable instructions, data structures, program modules, or other data. Exemplary computer storage media may include RAM, ROM, EEPROM, flash memory or other memory technologies, CD-ROM, digital versatile disk (DVD) or other optical storage devices, magnetic cassettes, magnetic tapes, magnetic disk storage devices or other magnetic storage devices, or any other media that can be used to store desired information and are accessible by a computer.

[0080] In the embodiment illustrated in Figure 20, one or more of the apparatus 100, patient support system 602, patient modeling application 608, and / or any other devices / components described herein may be configured to perform a method 2000 which includes determining a region of interest (ROI) in a 3D model of a part of a subject's body in 2010.

[0081] In 2020, a plane was determined that crossed a portion of the subject's body based on the center of the ROI, and the plane included multiple pairs of positions along the plane's contour.

[0082] In 2030, a modified plane is generated by adjusting one or more positions from a pair of positions based on anatomical constraints. The anatomical constraints may be based on the anatomical features of a part of the subject's body. For example, a first electric field generated by a first transducer array may be simulated at a first position, a second electric field generated by a second transducer array may be simulated at a second position opposite to the first position, and the simulated electric field distribution may be determined based on the first and second electric fields. In some cases, a third electric field generated by a first transducer array may be simulated at a third position, a fourth electric field generated by a second transducer array may be simulated at a fourth position opposite to the third position, and the simulated electric field distribution may be determined based on the third and fourth electric fields.

[0083] In step 2040, the simulated electric field distribution is determined for each pair of positions among multiple pairs of positions on the modified plane. For example, as follows:

[0084] In 2050, the dose metric is determined for each pair of locations among multiple pairs of locations, based on the simulated electric field distribution.

[0085] In 2060, one or more sets of pairs of positions among multiple pairs of positions that satisfy the conditions for the angular constraint between pairs of transducer arrays are determined. For example, the angular constraint may be and / or represent orthogonal angles between multiple pairs of transducer arrays. The angular constraint may be and / or represent a range of angles between multiple pairs of transducer arrays.

[0086] In 2070, one or more candidate transducer array layout maps are determined based on one or more sets of pairs of locations that satisfy the dose metric and angle limiting conditions.

[0087] In some cases, Method 2000 may include adjusting the simulated orientation or simulated position for at least one transducer array at at least one location in one or more candidate transducer array layout maps, and determining a final transducer array layout map based on the adjustment of the simulated orientation or simulated position for at least one transducer array.

[0088] In the embodiment illustrated in Figure 21, one or more of the apparatus 100, patient support system 602, patient modeling application 608, and / or any other devices / components described herein may be configured to perform a method 2100 which includes determining a three-dimensional (3D) model of a portion of the subject's body.

[0089] In 2120, the region of interest (ROI) within the 3D model of a part of the subject's body is determined.

[0090] In method 2130, for each of a plurality of locations relative to a pair of transducer arrays, an electric field distribution map is determined based on a 3D model, a ROI, and anatomical restriction parameters. The anatomical restriction parameters may indicate one or more locations in the cross-section of the ROI that should be excluded from use in determining the electric field distribution map. In some cases, method 2100 may include determining a plane that crosses a portion of the subject's body based on the center of the ROI, wherein the plane includes a plurality of pairs of locations relative to a pair of transducer arrays along the contour of the plane, and generating a modified plane by adjusting one or more of the plurality of locations based on anatomical restriction parameters.

[0091] In 2140, for each of the multiple combinations of pairs of transducer arrays, multiple dose metrics within the ROI are determined based on the electric field distribution map. The multiple dose metrics may be based on the simulated electric field generated for each of the multiple combinations of pairs of transducer arrays.

[0092] In 2150, a plan view of one or more candidate transducer array layouts is determined based on angle limiting parameters and multiple dose metrics within the ROI. In some cases, the angle limiting parameters may represent orthogonal angles between multiple pairs of transducer arrays. In some cases, the angle limiting parameters may represent a range of angles between multiple pairs of transducer arrays.

[0093] In 2160, for each of the one or more candidate transducer array layout plans, one or more adjusted candidate transducer array layout plans are determined by adjusting the position or orientation of one or more transducer arrays in a pair of transducer arrays.

[0094] In 2170, the adjusted dose metric within the ROI is determined for each adjusted candidate transducer array layout plan.

[0095] In 2180, the final transducer array layout plan is determined from the adjusted candidate transducer array layout plan based on the adjusted dose metric within the ROI.

[0096] Taking into consideration the apparatus, systems, and methods described herein, as well as variations thereof, some more detailed embodiments of the invention are described below. However, these detailed embodiments should not be construed as having any limiting effect on any different claims, including different or more general teachings described herein, or as limiting any “particular” embodiment in any way other than the inherent meaning of the words used therein.

[0097] Embodiment 1: A method comprising: determining a region of interest (ROI) in a 3D model of a part of a subject's body; determining a plane that crosses the part of the subject's body based on the center of the ROI, wherein the plane includes a plurality of pairs of positions along the contour of the plane; generating a modified plane by adjusting one or more of the plurality of pairs of positions based on anatomical constraints; determining a simulated electric field distribution for each pair of positions in the plurality of pairs of positions on the modified plane; determining a dose metric for each pair of positions in the plurality of pairs of positions based on the simulated electric field distribution; determining one or more sets of pairs of positions in the plurality of pairs of positions that satisfy the angular constraint conditions between pairs of transducer arrays; and determining one or more candidate transducer array layout maps based on the dose metric and the set of pairs of positions that satisfy the angular constraint conditions.

[0098] Embodiment 2: An embodiment according to any one of the prior embodiments, further comprising adjusting the simulated orientation or simulated position for at least one transducer array at at least one location of one or more candidate transducer array layout maps, and determining a final transducer array layout map based on the adjustment of the simulated orientation or simulated position for at least one transducer array.

[0099] Embodiment 3: An embodiment described in any one of the prior embodiments, wherein the anatomical limitation includes the anatomical features of a part of the subject's body.

[0100] Embodiment 4: An embodiment described in any one of the prior embodiments, wherein the angle limit includes orthogonal angles between multiple pairs of transducer arrays.

[0101] Embodiment 5: An embodiment described in any one of the prior embodiments, wherein the angle limit includes a range of angles between a plurality of pairs of transducer arrays.

[0102] Embodiment 6: An embodiment according to any one of the prior embodiments, wherein determining a simulated electric field distribution for each pair of positions among a plurality of pairs of positions on a modified plane includes simulating a first electric field generated by a first transducer array at a first position, simulating a second electric field generated by a second transducer array at a second position opposite to the first position, and determining a simulated electric field distribution based on the first and second electric fields.

[0103] Embodiment 7: An embodiment according to any one of the prior embodiments, further comprising simulating a third electric field generated by a first transducer array at a third position; simulating a fourth electric field generated by a second transducer array at a fourth position opposite to the third position; and determining a simulated electric field distribution based on the third and fourth electric fields.

[0104] Embodiment 8: An embodiment according to any one of the prior embodiments, wherein determining a transducer array layout plan based on a combination of multiple pairs of transducer arrays includes determining one or more adjusted candidate transducer array layout plan for each of one or more candidate transducer array layout plan by adjusting the position or orientation of one or more transducer arrays of a first pair of transducer arrays or one or more transducer arrays of a second pair of transducer arrays; determining an adjusted dose metric in the ROI for each adjusted candidate transducer array layout plan; and determining a final transducer array layout plan from the adjusted candidate transducer array layout plan based on the adjusted dose metric in the ROI.

[0105] Embodiment 9: A device comprising one or more processors and a memory for storing processor-executable instructions, the memory which, when the instructions are executed by one or more processors, causes the device to execute the method of any one of the embodiments described in Embodiments 1 to 8.

[0106] Embodiment 10: One or more non-temporary computer-readable media for storing processor-executable instructions, wherein, when executed by the processor, the instructions cause the processor to execute the method of any one of Embodiments 1 to 8.

[0107] Embodiment 11: A method comprising: determining a three-dimensional (3D) model of a portion of a subject's body; determining a region of interest (ROI) within the 3D model of the portion of the subject's body; determining an electric field distribution map for each of a plurality of positions relative to a pair of transducer arrays, based on the 3D model, ROI, and anatomical limiting parameters; determining a plurality of dose metrics within the ROI for each of a plurality of combinations of two pairs of transducer arrays, based on the electric field distribution map; and determining one or more candidate transducer array layouts based on the angular limiting parameters and the plurality of dose metrics within the ROI. A method comprising: determining a plan view; determining one or more adjusted candidate transducer array layout plan views for each of one or more candidate transducer array layout plan views by adjusting the position or orientation of one or more transducer arrays in a pair of transducer arrays; determining an adjusted dose metric within an ROI for each adjusted candidate transducer array layout plan view; and determining a final transducer array layout plan view from the adjusted candidate transducer array layout plan views based on the adjusted dose metric within an ROI.

[0108] Embodiment 12: An embodiment of Embodiment 11, further comprising adjusting the simulated orientation or simulated position for at least one transducer array at at least one location of one or more candidate transducer array layout maps, and determining a final transducer array layout map based on the adjustment of the simulated orientation or simulated position for at least one transducer array.

[0109] Embodiment 13: An embodiment according to any one of Embodiments 11 to 12, wherein the anatomical restriction parameter indicates one or more locations in the cross-section of the ROI that should be excluded from use in determining the electric field distribution map.

[0110] Embodiment 14: An embodiment according to any one of Embodiments 11 to 13, wherein the angle limiting parameter indicates the orthogonal angle between multiple pairs of transducer arrays.

[0111] Embodiment 15: An embodiment according to any one of Embodiments 11 to 14, wherein the angle limiting parameter indicates an angle range between multiple pairs of transducer arrays.

[0112] Embodiment 16: An embodiment according to any one of Embodiments 11 to 15, further comprising determining a plane that crosses a portion of a subject's body based on the center of the ROI, wherein the plane includes a plurality of pairs of positions relative to a pair of transducer arrays along the contour of the plane, and adjusting one or more positions of the plurality of positions based on anatomical restriction parameters to generate a modified plane.

[0113] Embodiment 17: An embodiment according to any one of Embodiments 11 to 16, wherein the multiple dose metrics are based on a simulated electric field generated for each combination of multiple combinations of two pairs of transducer arrays.

[0114] Embodiment 18: A device comprising one or more processors and a memory for storing processor-executable instructions, wherein when the instructions are executed by one or more processors, the memory causes the device to execute the method of any one of the embodiments described in Embodiments 11 to 17.

[0115] Embodiment 19: One or more non-temporary computer-readable media for storing processor-executable instructions, wherein, when executed by the processor, the instructions cause the processor to execute the method of any one of Embodiments 11 to 17.

[0116] Unless otherwise specified, no method described herein is ever intended to be construed as requiring its steps to be performed in a particular order. Therefore, where a method claim does not actually describe the order in which its steps should follow, or where it is not otherwise specifically stated in the claim or description that the steps should be limited to a particular order, no order is ever intended to be inferred. This applies to any possible implicit grounds for interpretation, including logical issues relating to the sequence or flow of steps, obvious meanings derived from grammatical construction or punctuation, and the number or type of embodiments described herein.

[0117] While methods and systems have been described in relation to preferred embodiments and specific examples, the embodiments herein are intended to be illustrative rather than restrictive in all respects, and the scope is not intended to be limited to the specific embodiments described.

[0118] Unless otherwise specified, no method described herein is ever intended to be construed as requiring its steps to be performed in a particular order. Therefore, where a method claim does not actually describe the order in which its steps should follow, or where it is not otherwise specifically stated in the claim or description that the steps should be limited to a particular order, no order is ever intended to be inferred. This applies to any possible implicit grounds for interpretation, including logical issues relating to the sequence or flow of steps, obvious meanings derived from grammatical construction or punctuation, and the number or type of embodiments described herein.

[0119] It will be apparent to those skilled in the art that various modifications and changes can be made without departing from the scope or spirit. Other embodiments will become apparent to those skilled in the art upon consideration of the details and practices disclosed herein. The details and examples are intended to be considered illustrative only, and the true scope and spirit are given by the following claims. [Explanation of symbols]

[0120] 100 devices 102 Electric field generator 104 transducer array 104a Transducer Array 104b Transducer Array 106 Processors 108 Signal Generator 110 Control Software 112 Conductive Leads 114 Output 116 Electrode 118 Flexible circuit board 120 Hypoallergenic Medical Bandages 120a and 120b Hypoallergenic Medical Bandages 302 Skin surface 304 Tumor 306 Bone tissue 308 Brain tissue 310 Police Box Electric Field 600 System 602 Patient Support System 606 Field Generator (EFG) Configuration Applications 608 Patient Modeling Application 610 Image Data 800 Three-Dimensional Array Layout Map 1000 ways 1102 Cross-section 1104 Area of ​​Interest 1106 position 1106A:1106F position 1106B:1106G Opposite position 1106D:1106H Opposite position 1106E:1106I Opposite position 1106B:1106C position 1108 Electric field 1202 Valid Zone 1402 Anatomical limitations 1404 Anatomical limitations 1900 environment 1908 Processor 1910 Memory System 1912 Input / Output (I / O) Interface 1914 Network Interface 1916 Local Interface 1918 Operating System (O / S) 2000 methods 2100 method

Claims

1. A method performed by a computer, A step of determining a region of interest (ROI) in a 3D model of a part of a subject's body, wherein the 3D model is configured to determine the distribution of an externally applied electric field passing through the part of the subject's body; A step of determining a plane that passes through the ROI and crosses the portion of the subject's body, wherein the plane includes a plurality of pairs of positions along the contour of the plane, and the line segments connecting each of the plurality of pairs pass through the ROI. The steps of generating a modified plane by adjusting one or more of the pairs of positions based on anatomical constraints indicating the positions on the subject's body where the placement of the transducer array should be restricted, The steps include determining the simulated electric field distribution based on the 3D model for each pair of positions among the plurality of pairs of positions on the modified plane, The steps include determining the dose metric in the ROI of the electric field generated by each pair of positions among the plurality of pairs of positions, based on the simulated electric field distribution, The steps include determining one or more sets of pairs of positions among the plurality of pairs of positions that satisfy the condition of the angle between each pair of positions among the plurality of pairs of positions, A method comprising the step of determining one or more candidate transducer array layout maps based on one or more sets of pairs of positions that satisfy the dose metric and angle conditions.

2. The steps include adjusting the simulated orientation or simulated position for at least one transducer array at at least one location in the one or more candidate transducer array layout maps, The method according to claim 1, further comprising the step of determining a final transducer array layout map based on the step of adjusting the simulated orientation or the simulated position for the at least one transducer array.

3. The method according to claim 1, wherein the anatomical restriction includes the anatomical features of the part of the body of the subject.

4. The method according to claim 1, wherein the angle condition includes the condition that the angle between two of the plurality of pairs is an orthogonal angle.

5. The method according to claim 1, wherein the angle condition includes the condition that the angle between two of the plurality of pairs is within a predetermined angle range.

6. The step of determining the simulated electric field distribution for each pair of positions among the plurality of pairs of positions on the modified plane is: The steps include simulating a first electric field generated by a first transducer array at a first position, The steps include simulating a second electric field generated by a second transducer array at a second position opposite to the first position, The method according to claim 1, further comprising the step of determining the simulated electric field distribution based on the first electric field and the second electric field.

7. The steps include simulating a third electric field generated by the first transducer array at a third position, The steps include simulating a fourth electric field generated by the second transducer array at a fourth position opposite to the third position, The method according to claim 6, further comprising the step of determining the simulated electric field distribution based on the third electric field and the fourth electric field.

8. It is a device, One or more processors, A device comprising: a memory for storing processor-executable instructions, wherein when the processor-executable instructions are executed by one or more processors, the memory causes the device to execute the method according to any one of claims 1 to 7.

9. A computer program comprising instructions causing a computer to perform the method described in any one of claims 1 to 7.

10. A method performed by a computer, A step of determining a three-dimensional (3D) model of a part of a subject's body, wherein the 3D model is configured to determine the distribution of an externally applied electric field passing through the part of the subject's body; The steps include determining a region of interest (ROI) within the 3D model of the subject's body, A step of determining an electric field distribution map for each of a plurality of positions relative to a pair of transducer arrays, based on the 3D model, the ROI, and anatomical constraints, wherein the anatomical constraints indicate locations on the subject's body where the placement of the transducer arrays should be restricted, and the line segments connecting the pair of transducer arrays pass through the ROI. For each of several combinations of two pairs of transducer arrays, the steps include determining several dose metrics within the ROI based on the electric field distribution map, The steps include determining one or more candidate transducer array layout plans based on the angle conditions between multiple pairs of transducer arrays and the multiple dose metrics within the ROI, For each of the one or more candidate transducer array layout plans, the step of determining one or more adjusted candidate transducer array layout plans by adjusting the position or orientation of one or more transducer arrays in the pair of transducer arrays, For each adjusted candidate transducer array layout plan, the steps include determining the adjusted dose metric within the ROI, A method comprising the step of determining a final transducer array layout plan from the adjusted candidate transducer array layout plan based on the adjusted dose metric within the ROI.

11. The method according to claim 10, wherein the angle condition includes the condition that the angle between two of the plurality of pairs is an orthogonal angle.

12. The method according to claim 10, wherein the angle condition includes the condition that the angle between two of the plurality of pairs is within a predetermined angle range.

13. A step of determining a plane that crosses the portion of the subject's body based on the center of the ROI, wherein the plane includes a plurality of pairs of positions of a transducer array relative to the pair along the contour of the plane. The method according to claim 10, further comprising the step of adjusting one or more of the pairs of positions based on the anatomical constraints to generate a modified plane.

14. The method according to claim 10, wherein the plurality of dose metrics are based on simulated electric fields generated for each of the plurality of combinations of two pairs of transducer arrays.

15. It is a device, One or more processors, A device comprising: a memory for storing processor-executable instructions, wherein when the processor-executable instructions are executed by the one or more processors, the memory causes the device to execute the method according to any one of claims 10 to 14.

16. A computer program comprising instructions causing a computer to perform the method described in any one of claims 10 to 14.

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