Patent Description:
Tumor treating fields (TTFields) are low intensity alternating electric fields within the intermediate frequency range, which may be used to treat tumors as described in <CIT>. TTFields are induced non-invasively into a region of interest by transducers placed on the patient's body and applying AC voltages between the transducers. Conventionally, a first pair of transducers and a second pair of transducers are placed on the subject's body. AC voltage is applied between the first pair of transducers for a first interval of time to generate an electric field with field lines generally running in the front-back direction. Then, AC voltage is applied at the same frequency between the second pair of transducers for a second interval of time to generate an electric field with field lines generally running in the right-left direction. The system then repeats this two-step sequence throughout the treatment.

<CIT> discloses an apparatus and method for treating a target region in a subject's body with tumor treating fields (TTFields), the target region being located in a portion of the subject's body that has a longitudinal axis.

<CIT> discloses a system comprising a plurality of coils and an electromagnetic field generator that energizes the plurality of coils so as to apply a tumor treating field (TTField) to a specimen region.

<CIT> discloses a method of determining where to position sets of electrode elements in applying an alternating electric field to a target region in a person's spinal anatomy.

<CIT> discloses a method of optimizing positions of a plurality of electrodes placed on a subject's body, where the electrodes are used to impose an electric field in target tissue within an anatomic volume.

<CIT> discloses a method of applying an alternating electric field to a person's brain.

<NPL>) discloses computational approaches used to characterize tumor treating fields (TTFields), in particular the macroscopic spatial distribution of TTFields generated in the human head and the microscopic field distribution in tumor cells.

<CIT> discloses a method of assisting transducer placements on a subject's body for applying tumor treating fields.

The present invention is directed to a computer-implemented method to determine placement of transducers on a subject's body for inducing tumor treating fields according to claim <NUM>.

The above aspect of the invention is exemplary, and other aspects and variations of the invention will be apparent from the following detailed description of embodiments.

This application describes exemplary methods and apparatuses to apply TTFields to a torso of a subject's body and may be used to treat one or more cancers located in the torso of the subject's body. The torso is the central part of the subject's body including the thorax and the abdomen. Many abdominal cancers may metastasize to the thorax area and vice versa. For this reason, it may be beneficial to deliver TTFields to the entire thorax and abdomen simultaneously. Pre-clinical experiments suggest that in order exert a therapeutic effect, TTField intensities should exceed a threshold of about <NUM> V/cm.

<FIG> describes an example method <NUM> of applying TTFields to the torso of a subject's body. With reference to <FIG>, at step S102, the method <NUM> comprises locating a first transducer at a first location of the subject's body, wherein the first location is on the torso of the subject's body. At step S104, a second transducer is located at a second location of the subject's body, wherein the second location is below the torso of the subject's body. Below the torso of the subject's body may include, for example, on the thigh of the subject's body. The first and second transducers form the first pair of transducers. The first and second transducers are capacitively coupled. In another example, the transducers are not capacitively coupled.

At step S106, a third transducer is located at a third location of the subject's body, wherein the third location is on the torso of the subject's body and is not overlapping with the first location. At step S108, a fourth transducer is located at a fourth location of the subject's body, wherein the fourth location is below the torso of the subject's body and is not overlapping with the second location. The third and fourth transducers form the second pair of transducers. The third and fourth transducers are capacitively coupled. In another example, the transducers are not capacitively coupled. The transducers may be electric field generators. One or more of the first, second, third, and the fourth transducers may comprise an array, or grouping of electrode elements. Each array of electrode elements may comprise a plurality of ceramic disks, each disk being approximately <NUM> in diameter and approximately <NUM> in thickness. Each transducer may cover a surface area of approximately <NUM> to <NUM><NUM>.

At step S110, a first electric field is induced between the first transducer and the second transducer for a first time period. The first electric field is induced by applying a first AC voltage generated by an AC generator to the first pair of transducers and has, for example, a low intensity (e.g., <NUM>-<NUM> V/cm) and intermediate frequency range (e.g., <NUM>-<NUM>, or in some cases, <NUM>-<NUM>). The first AC voltage is applied to the first pair of transducers for the first time period (e.g., one second). At step S112, after the first time period, the generation of the first electric field is ceased. That is, the AC generator stops generating the first AC voltage.

At step S114, a second electric field is induced between the third transducer and the fourth transducer for a second time period. The second electric field is induced by applying a second AC voltage generated by the AC generator to the second pair of transducers. The second electric field may or may not have the same intensity and frequency as the first electric field. The second AC voltage is applied to the second pair of transducers for the second time period. The first time period and the second time period may be the same or different. At step S116, after the second time period, the generation of the second electric field is ceased. That is, the AC generator stops generating the second AC voltage. In some embodiments, after the second electric field is ceased, the process automatically repeats (arrow <NUM>) in steps S110, S112, S114, and S116. The electric fields are induced in a thorax and an abdomen of the subject's body.

In other embodiments, the method <NUM> may further include changing the locations of the subject's body where the electric field is applied. This may help to mitigate the risk of skin irritation, thereby reducing any discomfort of the subject. The method <NUM> may include steps S502 and S504. At step S502, a third time period is checked. The third time period (which may be in hours or days) determines when the locations of the transducers should be changed. Once the third time period has ended, the locations of the transducers are moved to new locations on the subject's body. If the third time period is not over, flow proceeds to step S110. If the third time period is over, flow proceeds to step S504. At step S504, the transducers are re-located on the subject's body. The first transducer, the second transducer, the third transducer and the fourth transducer are re-located to a new first location, a new second location, a new third location, and a new fourth location of the subject's body. The new first, second, third, and fourth locations do not overlap with the previous first, second, third, and fourth locations, respectively. In alternative embodiments, the new locations may partially overlap with the previous locations. After the transducers are re-located at step S504, flow proceeds to step S110 and the flow repeats.

<FIG> depicts an example of a transducer layout for applying TTFields to a subject's body. <FIG> depicts one example of a transducer layout of two pairs of transducers with four transducers used for applying TTFields to the torso of the subject's body. In this example, the first transducer 21A and the third transducer 23A are located on the thorax of the subject's body, and the second transducer 22A and the fourth transducer 24A are located on the thighs of the subject's body. In one example, the first transducer 21A is located on the front of the thorax, the third transducer 23A is located on the back of the thorax, the second transducer 22A is located on a back or an outer side of the thighs, and the fourth transducer 24A is located on the front or inside of the thighs. In a more specific example, the first transducer 21A is located on the front of the right thorax; the third transducer 23A is located on the back of the left thorax; the second transducer 22A is located on the back of the left thigh; and the fourth transducer 24A is located on the front of the right thigh. As to pairs, the first transducer 21A and the second transducer 22A may form a first pair of transducers, and the third transducer 23A and the fourth transducer 24A may form a second pair of transducers. In other embodiments, more than two pairs of transducers may be used for applying TTFields to the subject's body.

<FIG> depict examples of transducer layouts with two pairs of transducers for applying TTFields to the subject's torso. In <FIG>, the first transducer 31A is located on the front of the right thorax, the second transducer 32A is located on the back of the left thigh, the third transducer 33A is located on the back of the right thorax, and the fourth transducer 34A is located on the front of the left thigh. The first and second transducers 31A and 32A may form a first pair of transducers, and the third and fourth transducers 33A and 34A may form a second pair of transducers. In another example, the first and fourth transducers 31A and 34A may form a first pair of transducers, and the third and second transducers 33A and 32A may form a second pair of transducers.

In <FIG>, the first transducer 31B is located on the front of the right thorax, the second transducer 32B is located on the back of the left thigh, the third transducer 33B is located on the front of the left thorax, and the fourth transducer 34B is located on the back of the right thigh. The first and second transducers 31B and 32B may form a first pair of transducers, and the third and fourth transducers 33B and 34B may form a second pair of transducers.

In <FIG>, the first transducer 31C is located on the front of the right thorax, the second transducer 32C is located on the front of the left thigh, the third transducer 33C is located on the front of the left thorax, and the fourth transducer 34C is located on the front of the right thigh. The first and second transducers 31C and 32C may form a first pair of transducers, and the third and fourth transducers 33C and 34C may form a second pair of transducers.

In <FIG>, the first transducer 31D is located on the front of the thorax, and the second transducer 32D and the fourth transducer 34D are located on the back of the left thigh and on the back of the right thigh, respectively. A first part 33D of the first transducer 31D and the second transducer 32D may form a first pair of transducers, and a second part 35D of the first transducer 31D and the fourth transducer 34D may form a second pair of transducers. In one example, the first part of the first transducer 33D does not overlap with the second part of the first transducer 35D. In another example, the first part of the first transducer 33D may partially overlap with the second part of the first transducer 35D.

In <FIG>, the first transducer 31E is located on the front of the right thorax, the third transducer 33E is located on the back of the right thorax, and the second transducer 32E is located on the front of the left thigh. The first and second transducers 31E and 32E may form a first pair of transducers, and the third and second transducers 33E and 32E may form a second pair of transducers.

<FIG> depict examples of transducer layouts with one pair of transducers for applying TTFields to the torso of the subject's body. Various combinations of these pairs of transducers or similar pairs of transducers may be used together. In <FIG>, the first transducer 41A is located on the front of the right thorax, and the second transducer 42A is located on the back of the left thigh. In <FIG>, the first transducer 41B is located on the back of the left thorax, and the second transducer 42B is located on the front of the right thigh. In <FIG>, the first transducer 41C is located on the back of the right thorax, and the second transducer 42C is located on the front of the left thigh. In <FIG>, the first transducer 41D is located below the left armpit, and the second transducer 42D is located on the outer side of the right thigh. Instead of the outer side of the thigh, the transducer may be located on the inner side of the thigh. In <FIG>, the first transducer 41E is located on the front of the right thorax, and the second transducer 42E is located on the front of the left thigh.

The locations of the transducers that are located below the torso may be flexible. For example, where a pair of transducers includes a first transducer located on the torso and a second transducer located below the torso, the location of the second transducer may be anywhere on the thigh of the subject's body (e.g., on a front, back, outer side, or inner side of a thigh, a combination thereof, or a partially or fully overlapping combination thereof).

Various combinations of pairs of transducers as discussed herein, or similar pairs of transducers, may be used together. Various locations of transducers, such as those discussed herein or in other locations, may be used. A transducer may be used in a single pair of transducers or in two or more pairs of transducers. A transducer may be partitioned to be used in a single pair of transducers or in two or more pairs of transducers. The transducers, the transducer locations, the pairs of transducers, and the two or more pairs of transducers discussed herein are not exhaustive.

<FIG> depict examples of re-locating the transducers on the torso of the subject's body. In the example depicted in <FIG>, the first transducer was located at the first location 61A and re-located at the third location 63A. The second transducer was located at the second location 62A and re-located at the fourth location 64A. The first location 61A is on the front of the right thorax, the third location 63A is on the back of the right thorax, the second location 62A is the back of the left thigh, and the fourth location 64A is the front of the left thigh.

In the example depicted in <FIG>, the first transducer was located at the first location 61B and re-located at the third location 63B. The second transducer was located at the second location 62B and re-located at the fourth location 64B. The first location 61B is below the left armpit, the third location 63B is below the right armpit, the second location 62B is on the outer side of the right thigh, and the fourth location 64B is on the outer side of the left thigh.

When re-locating transducers according to steps S502 and S504 of <FIG>, the transducers may be re-located to different areas of the subject's body than those illustrated in the examples of <FIG>. The transducers may be re-located to areas of the subject's body to deliver a similar or complementary amount of TTFields.

The structure of the transducers may take many forms. The transducers may be affixed to the subject's body or attached to or incorporated in clothing covering the subject's body. In <FIG>, the transducer 80A has a substrate 81A and a plurality of electrode elements 82A positioned on the substrate 81A. The substrate 81A is configured for attaching the transducer 80A to a subject's body. Suitable materials for the substrate 81A include, for example, cloth, foam, flexible plastic, and/or a conductive medical gel. The substrate 81A may be a layer of conducting medical gel with a minimum thickness of <NUM>. In this situation, the transducer 80A is affixed to the subject's body via the substrate 81A. The transducer may be conductive or nonconductive. <FIG> depicts another example of the structure of the transducer 80B. In this example, the transducer 80B includes a plurality of electrode elements 82B that are electrically and mechanically connected to one another without a substrate. In one example, the electrode elements 82B are connected to each other through conductive wires 83B.

The transducer may include any desired number of electrode elements 82A, 82B. Various shapes, sizes, and materials may be used for the electrode elements 82A, 82B. Any constructions for implementing the transducer (or electric field generating device) for use with embodiments of the invention may be used, as long as they are capable of (a) delivering TTFields to the subject's body and (b) being positioned at the locations specified herein.

<FIG> depicts one example of the configuration of one pair of transducers. In this example, the first transducer <NUM> includes <NUM> electrode elements <NUM> which are positioned on the substrate <NUM> and electrically and mechanically connected to one another through a conductive wiring <NUM>. Similarly, the second transducer <NUM> includes <NUM> electrode elements <NUM> which are positioned on the substrate <NUM> and electrically and mechanically connected to one another through a conductive wiring <NUM>. The first transducer <NUM> and the second transducer <NUM> are connected to an AC voltage generator <NUM> and a controller <NUM>. The controller <NUM> may include one or more processors and memory accessible by the one or more processors. The memory may store instructions that when executed by the one or more processors control the AC voltage generator <NUM> to implement one or more embodiments of the invention (e.g., by providing a first voltage to the first transducer and a second voltage to the second transducer).

<FIG> depicts an exemplary apparatus to determine locations of transducers for applying TTFields. In this example, the apparatus <NUM> includes one or more processors <NUM>, one or more output devices <NUM>, and a memory <NUM>. The memory <NUM> is accessible by the one or more processors <NUM> via a link <NUM> so the one or more processors <NUM> can read information from and write information to the memory <NUM>. In one example, based on user input <NUM>, the one or more processors <NUM> generate simulation results of a plurality of locations for attaching transducers, rank the plurality of locations, and make one or more recommendations to a user based on the ranking, which are output on the output devices <NUM>. In another example, the user may give feedback regarding the one or more recommendations through the output devices <NUM>, and the one or more processors <NUM> may generate different recommendations based on the feedback.

<FIG> is a flowchart describing an example method <NUM> for determining locations of transducers on a subject's body for applying TTFields. In <FIG>, at step S302, a plurality of first locations of the subject's body are selected to locate a first transducer, wherein the plurality of first locations are on the torso of the subject's body. At step S304, a plurality of second locations of the subject's body are selected to locate a second transducer, wherein the plurality of second locations are below the torso of the subject's body. Below the torso of the subject's body may include, for example, on the thigh of the subject's body. At step S306, pairs of first locations and second locations are selected. Each pair has one first location selected from the plurality of first locations and one second location selected from the plurality of second locations, and each pair has a different combination of first and second locations.

In some embodiments, the method <NUM> may incorporate a measure of heat removal potential of a subject's body to determine locations of transducers on the subject's body for applying TTFields. At step S1102, the method <NUM> may include accessing a mapping of heat removal potential at surface locations corresponding to surface locations of the subject's body. For example, step S1102 may include accessing a mapping of the subject's body indicating a heat removal potential at multiple surface locations of the subject's body, as discussed below.

At step S308, simulation results for an induced electric field in the torso of the subject's body are generated. Generating simulation results may include, for example: obtaining a three-dimensional model of AC electrical conductivity of the relevant anatomic volume; identifying the volume targeted for treatment within the three-dimensional model; automatically placing transducers on the three-dimensional model and setting relevant boundary conditions for the three-dimensional model; and calculating the electric field that develops within the model (e.g., using a Finite Element method analysis) once transducers have been placed on the model and boundary conditions applied. In an embodiment, for each pair, the induced electric field in the torso of the subject's body is simulated based at least partially on the mapping of heat removal potential accessed at step S1102 to obtain the simulation results.

At step S310, based on the simulation results, a ranking of the simulations results of each pair of locations is generated. This may involve, for example, running an optimization algorithm to find the layout that yields optimal electric field distributions within the target volume. The simulation results may be ranked in order of maximized electric field within the diseased regions of the subject's body. At step S312, based on the ranked simulations results, one or more recommendations of the pairs of first locations and second locations are generated. In an embodiment, the one or more ranked simulation results are selected based at least partially on the mapping of heat removal potential accessed at step S1102. At step S314, the one or more recommended pairs of first locations and second locations are output to the user.

<FIG> is a flowchart describing an example computer-implemented method for determining locations of transducers on a subject's body for applying TTFields. The computer comprises one or more processors and a memory accessible by the one or more processors, the memory storing instructions that when executed by the one or more processors cause the computer to perform the method <NUM>.

With reference to <FIG>, at step S1302, pairs of first locations and second locations are selected, each pair of locations having a first location to locate a first transducer and a second location to locate a second transducer. Each pair may have one first location selected from a plurality of first locations and one second location selected from a plurality of second locations. Each pair may have a different combination of first locations and second locations. One or more of the pairs of locations may include at least one location on the subject's torso.

At step S1304, a three-dimensional model of AC electrical conductivity (e.g., at the frequency that will be used for the TTFields treatment) of the relevant anatomic volume is obtained using any of a variety of approaches that will be apparent to persons skilled in the relevant arts. This three-dimensional model specifies the conductivity of each voxel.

At step S1306, the method <NUM> comprises obtaining, for each location in the plurality of pairs of locations on the subject's body, an indication of heat removal potential at a surface of the subject's body. The indication of heat removal potential at the surface of the subject's body may be proportional to an amount of blood circulation proximate the surface at the location of the subject's body.

In an example, the indication of heat removal potential at the surface of the subject's body may be proportional to an amount of muscle mass at the location of the subject's body. Even though muscle movement generates heat, areas of high muscle mass in a subject's body are generally more effective than areas of low muscle mass at moving heat away from the surface of the body due to increased blood circulation through the muscle. In some embodiments, the indication of heat removal potential at the surface of the subject's body may relate to an amount of sweat expected at the location of the subject's body, an amount of glandular tissue at the location, or whether clothing is expected to cover the location.

The method at step S <NUM> may include accessing a mapping <NUM> of relative muscle mass at surface locations of the subject's body; and obtaining, for each location in the plurality of pairs of locations on the subject's body, the amount of muscle mass at the location of the subject's body from the mapping <NUM>. The mapping may be a model of a human body including at least one portion of the body divided into a plurality of zones on the surface of the at least one portion of the body, and a relative muscle mass value corresponding to each zone. In an embodiment, the mapping <NUM> is selected from one or more predetermined models of muscle mass distribution in humans. For example, the mapping <NUM> may be: a standard mapping of relative muscle mass used for all human subjects; selected from a group of two standard mappings (for male subjects and female subjects) of relative muscle mass; or selected from a finite number of mappings of relative muscle mass in response to one or more user inputs such as, for example, sex, height, and weight. In an embodiment, the mapping <NUM> of relative muscle mass is generated for an individual subject based on an input of at least one measurement <NUM> of the subject's body. Such measurements <NUM> may include a height, weight, circumferential measurements of one or more of the subject's body parts (e.g., chest, waist, hips, forearm, wrist, neck, etc.), grip strength measurement, caliper measurement, or image data, among others.

In an example, the indication of heat removal potential at the surface of the subject's body may be proportional to a concentration of at least one of veins, arteries, or capillaries proximate the surface at the location of the subject's body. This relationship takes advantage of vascular changes that occur in a subject's body, such as constriction or enlargement of vessels in response to temperature changes (e.g., blood vessels expanding to remove heat from the area). Areas of the subject's body having more veins, arteries, and/or capillaries close to the surface may provide greater heat removal potential.

The method at step S <NUM> may include accessing a mapping <NUM> of at least one of veins, arteries, or capillaries proximate surface locations of the subject's body; and obtaining, for each location in the plurality of pairs of locations on the subject's body, the concentration of at least one of veins, arteries, or capillaries proximate the surface at the location of the subject's body from the mapping <NUM>. The mapping <NUM> may be a model of a human body including at least one portion of the body divided into a plurality of zones each representing part of the surface of the at least one portion of the body, and a concentration of at least one of veins, arteries, or capillaries proximate the surface corresponding to each zone. In an embodiment, the mapping <NUM> is selected from one or more predetermined models representing a typical circulatory system in humans. The mapping <NUM> may be: a standard mapping of concentrations of veins, arteries, and/or capillaries used for all human subjects; selected from a group of two standard mappings (for male subjects and female subjects) of a circulatory system; or generated based on image data for the subject.

At step S1312, the method <NUM> comprises selecting one or more recommended pairs of first locations and second locations. At step <NUM>, the one or more recommended pairs are selected based at least on the model of AC electrical conductivity of S1304 and the indication of heat removal potential of S1306 for each location. Since the one or more recommend pairs are selected based on the indication of heat removal potential of S1306, the one or more recommended pairs may include a location having a relatively high muscle mass, a high concentration of veins, arteries, and/or capillaries, and/or other markers of increased circulation. The one or more recommended pairs may comprise a location in a region of a torso of the subject. The one or more recommended pairs may comprise a location in a region of a shoulder, thigh, or thorax of the subject. At step S1314, the method <NUM> comprises outputting (e.g., to a user) the one or more recommended pairs of first locations and second locations.

<FIG> is a flowchart depicting an example method of performing step S <NUM> of <FIG>. At step S1400, the method may comprise simulating, for each pair of locations, an induced electric field in the portion of the subject's body between the first transducer and the second transducer of each pair, based on the model of AC electrical conductivity (S <NUM> of <FIG>) and the indication of heat removal potential (S <NUM> of <FIG>) at the surface of the subject's body for the locations of each pair. The indication of heat removal potential may be input to simulation software to generate the results. The heat removal potential at the pair locations may affect an amount of energy output via the transducers, since higher heat removal potential enables a subject's body to remove heat caused by transducers operating at higher power levels. The simulation may involve applying a weighting factor to transducer locations based on their heat removal potential. At step S1402, the method may comprise ranking simulation results of the pairs of first locations and second locations. At step S <NUM>, the method may comprise selecting one or more ranked simulation results as the one or more recommended location pairs.

<FIG> is a flowchart depicting another example method of performing step S1312 of <FIG>. At step S1500, the method may comprise simulating, for each pair of locations, an induced electric field in the portion of the subject's body between the first transducer and the second transducer of each pair based on the model of AC electrical conductivity (S1304 of <FIG>). At step S1502, the method may comprise ranking the simulation results of the pairs of first locations and second locations. At step S1504, the method may comprise selecting two or more potential pairs of first locations and second locations based on the ranked simulation results. At step S1506, the method may comprise comparing the indication of heat removal potential (S1306 of <FIG>) at the surface of the subject's body for locations of the two or more potential pairs. At step S1508, the method may comprise selecting one or more potential pairs having a highest indication of heat removal potential as the one or more recommended pairs of first locations and second locations. As such, the method of <FIG> involves using the indication of heat removal potential for various surface locations on the subject's body to break a tie between a plurality of transducer location pairs that according to the simulation results would yield substantially similar electric field deliveries to the target region.

Table <NUM> shows simulation results for Sample Nos. <NUM>-<NUM> based on step S308 in <FIG>. Each transducer layout of Sample Nos. <NUM>-<NUM> includes one pair of transducers (a first transducer and a second transducer). Each transducer in Sample Nos. <NUM>-<NUM>, <NUM>, <NUM>, and <NUM> include <NUM> electrode elements, and each transducer in Sample Nos. <NUM> and <NUM> include <NUM> electrode elements. All of the field intensities depicted herein were generated by running simulations at <NUM> using a DUKE model by ZMT (Zürich), a highly detailed computational human male phantom. The simulations were performed using the low frequency solver of the Sim4Life software package, which uses a Finite Differences Method to solve the model. Consequently, discretization is performed by dividing the model into voxels (voxelization). To optimize accuracy with calculation speed, the model was voxelized with a maximum resolution of <NUM> around the disks. In one example, the resolution within the body was between <NUM> and <NUM>. To simulate delivery of TTFields using the NovoTTF-<NUM>(P), Dirichlet conditions (e.g., constant voltage at a frequency of <NUM>) were applied to the outer faces of the disks of the transducers. All disks within one pair of transducers were set to the same voltage level. The difference in voltage between the two transducers within the pair was set so that the average current per-disk was <NUM> mA peak to peak, which resulted in the total current of <NUM> A peak to peak for transducers with <NUM> disks and <NUM> A peak to peak for transducers with <NUM> disks.

For each of Samples <NUM>-<NUM>, the numbers of electrode elements in each transducer and the locations of each transducer on the subject's body (and a representative figure) are provided in Table <NUM>. The simulation results are also provided in Table <NUM>. The simulation results include a mean electric field intensity in the torso and a percentage of the torso volume that received an intensity above <NUM> V/cm.

From the simulation results of Sample Nos. <NUM> to <NUM>, the torso of the subject's body has an average electric field intensity of at least <NUM> V/cm, and at least <NUM>% of volume of the torso of the subject's body has electric field intensities of at least <NUM> V/cm. From the simulation results of Sample Nos. <NUM> and <NUM>, the torso of the subject's body has an average electric field intensity of at least <NUM> V/cm, and at least <NUM>% of volume of the torso of the subject's body has electric field intensities of at least <NUM> V/cm. For Samples <NUM>, <NUM>, <NUM>, and <NUM>, the simulation results show that placing the transducers in the front or in the back of the thorax does not significantly influence the mean electric field intensity and the percentage of torso volume that received an intensity above <NUM> V/cm. As such, the locations of the transducers may be selected based on comfort level and convenience without compromising the treatment effects of the TTFields.

Claim 1:
A computer-implemented method to determine placement of transducers (21A, 22A, 23A, 24A; 31A, 32A, 33A, 34A; 31B, 32B, 33B, 34B; 31C, 32C, 33C, 34C; 31D, 32D, 33D, 34D, 35D; 31E, 32E, 33E; 41A-E, 42A-E; 61A, B, 62A, B, 63A, B, 64A, B) on a subject's body for inducing tumor treating fields, the computer comprising one or more processors (<NUM>) and memory (<NUM>) accessible by the one or more processors (<NUM>), the memory (<NUM>) storing instructions that, when executed by the one or more processors (<NUM>), cause the computer to perform the method, the method comprising:
selecting a plurality of pairs of locations on the subject's body, each pair of locations having a first location to locate a first transducer and a second location to locate a second transducer;
obtaining a model of AC electrical conductivity in a portion of the subject's body; obtaining, for each location in the pairs of locations, an indication of heat removal potential at a surface of the subject's body;
selecting one or more recommended pairs of first and second locations based at least on the model of AC electrical conductivity and the indication of heat removal potential for each location; and
outputting the one or more recommended pairs of first and second locations.