EP-4735102-A1 - ADAPTING ARRAY LAYOUTS TO ACCOUNT FOR TUMOR PROGRESSION

EP4735102A1EP 4735102 A1EP4735102 A1EP 4735102A1EP-4735102-A1

Abstract

A computer-implemented method comprising: obtaining a three-dimensional model of a subject, the model comprising voxels; identifying a gross tumor volume for the three- dimensional model, the gross tumor volume representing a current location of a tumor in the subject; identifying a primary clinical target volume for the three-dimensional model, the primary clinical target volume having a larger volume than the gross tumor volume, the primary clinical target volume representing an approximation of the current location of the tumor in the subject; identifying a predictive clinical target volume for the three-dimensional model, the predictive clinical target volume having a larger volume than the primary clinical target volume, the predictive clinical target volume representing a predicted future location of the tumor in the subject; and selecting at least one transducer layout for delivering tumor treating fields to the subject based on the primary clinical target volume and the predictive clinical target volume.

Inventors

NADAV, Shapira
BERGER, BRIAN

Assignees

Novocure GmbH

Dates

Publication Date: 20260506
Application Date: 20240529

Claims (15)

1. A computer-implemented method for selecting at least one transducer layout for delivering tumor treating fields to a subject, the method comprising: obtaining a three-dimensional model of the subject, the model comprising voxels; identifying a gross tumor volume for the three-dimensional model, the gross tumor volume representing a current location of a tumor in the subject; identifying a primary clinical target volume for the three-dimensional model, the primary clinical target volume having a larger volume than the gross tumor volume, the primary clinical target volume representing an approximation of the current location of the tumor in the subject; identifying a predictive clinical target volume for the three-dimensional model, the predictive clinical target volume having a larger volume than the primary clinical target volume, the predictive clinical target volume representing a predicted future location of the tumor in the subject; and selecting at least one transducer layout for delivering tumor treating fields to the subject based on the primary clinical target volume and the predictive clinical target volume.
2. The computer-implemented method of claim 1, wherein the primary clinical target volume and the gross tumor volume have approximately a same shape.
3. The computer-implemented method of claim 1, wherein a surface of the primary clinical target volume is approximately 1 mm to approximately 5 mm outside a surface of the gross tumor volume.
4. The computer-implemented method of claim 1, wherein the approximation of the current location of the tumor in the subject represented by the primary clinical target volume accounts for at least one of an error in identifying the gross tumor volume or a portion of the tumor undetected in the gross tumor volume.
5. The computer-implemented method of claim 1, wherein the predictive clinical target volume and the primary clinical target volume have different shapes.
6. The computer-implemented method of claim 1, wherein the predictive clinical target volume comprises a plurality of non-contiguous volumes.
7. The computer-implemented method of claim 1, wherein the predictive clinical target volume is based on a progression of the tumor in the subject over a period of time.
8. The computer-implemented method of claim 1, wherein the predictive clinical target volume is determined using a predictive model for a tumor similar to the tumor in the subject, the predictive model determines a future location of the tumor in the subject based on a current location of the tumor and at least one of the subject’s medical background, an indication or type of the tumor, a subtype or classification of the tumor, and past progression of the tumor.
9. The computer-implemented method of claim 1, wherein the predictive clinical target volume is determined using a trained machine learning model, the trained machine learning model is trained to predict a future location of a tumor similar to the tumor in the subject.
10. The computer-implemented method of claim 1, further comprising: identifying a plurality of predictive clinical target volumes for the three-dimensional model, wherein the plurality of predictive clinical target volumes includes the predictive clinical target volume; and assigning a weight to each of the predictive clinical target volumes, wherein each weight represents a likelihood of the predicted future location of the tumor in the subject for the respective the predictive clinical target volume, and wherein selecting at least one transducer layout for delivering tumor treating fields to the subject is based on the primary clinical target volume, the plurality of predictive clinical target volumes, and the weights for the plurality of predictive clinical target volumes.
11. The computer-implemented method of claim 1, further comprising: identifying a differential clinical target volume as a difference between the primary clinical target volume and the predictive clinical target volume; calculating a first tumor treating fields dosage for the primary clinical target volume; calculating a second tumor treating fields dosage for the differential clinical target volume, wherein the second tumor treating fields dosage for the differential clinical target volume and the first tumor treating fields dosage for the primary clinical target volume are not identical.
12. The computer-implemented method of claim 11, wherein the second tumor treating fields dosage for the differential clinical target volume is less than the first tumor treating fields dosage for the primary clinical target volume.
13. The computer-implemented method of claim 11, wherein the first tumor treating fields dosage is calculated assuming the second tumor treating fields dosage is not applied simultaneously with the first tumor treating fields dosage, and wherein the second tumor treating fields dosage is calculated assuming the first tumor treating fields dosage is not applied simultaneously with the second tumor treating fields dosage.
14. An apparatus for selecting at least one transducer layout for delivering tumor treating fields to a subject, the apparatus comprising: one or more processors; and memory accessible by the one or more processors, the memory storing instructions that when executed by the one or more processors, cause the apparatus to: obtain a three-dimensional model of the subject, the model comprising voxels; identify a gross tumor volume for the three-dimensional model, the gross tumor volume representing a current location of a tumor in the subject; identify a primary clinical target volume for the three-dimensional model, the primary clinical target volume having a larger volume than the gross tumor volume, the primary clinical target volume representing an approximation of the current location of the tumor in the subject; identify a predictive clinical target volume for the three-dimensional model, the predictive clinical target volume having a larger volume than the primary clinical target volume, the predictive clinical target volume is based on a progression of the tumor in the subject over a period of time; and select at least one transducer layout for delivering tumor treating fields to the subject based on the primary clinical target volume and the predictive clinical target volume.
15. A non-transitory processor readable medium for selecting at least one transducer layout for delivering tumor treating fields to a subject and containing a set of instructions thereon that when executed by a processor cause the processor to: obtain a three-dimensional model of the subject, the model comprising voxels; identify a gross tumor volume for the three-dimensional model, the gross tumor volume representing a current location of a tumor in the subject; identify a primary clinical target volume for the three-dimensional model, the primary clinical target volume having a larger volume than the gross tumor volume, the primary clinical target volume representing an approximation of the current location of the tumor in the subject; identify a predictive clinical target volume for the three-dimensional model, the predictive clinical target volume having a larger volume than the primary clinical target volume, the predictive clinical target volume representing a predicted future location of the tumor in the subject; and select at least one transducer layout for delivering tumor treating fields to the subject based on tumor treating fields dosages for the primary clinical target volume and the predictive clinical target volume.

Description

ADAPTING ARRAY LAYOUTS TO ACCOUNT FOR TUMOR PROGRESSION CROSS-REFERENCE TO RELATED APPLICATIONS [0001] This application claims priority to U.S. Patent Application No. 18/675,714 filed May 28, 2024 and U.S. Provisional Application No. 63/523,853 filed June 28, 2023, the contents of each of which are incorporated by reference herein in their entirety. BACKGROUND [0002] Tumor treating fields (TTFields) are low intensity alternating electric fields within the intermediate frequency range (for example, 50 kHz to 1 MHz), which may be used to treat tumors as described in U.S. Patent No. 7,565,205. TTFields are induced non- invasively into the region of interest by transducers placed on the patient’s body and applying AC voltages between the transducers. Conventionally, transducers used to generate TTFields include a plurality of electrode elements comprising ceramic disks. One side of each ceramic disk is positioned against the patient’s skin, and the other side of each disc has a conductive backing. Electrical signals are applied to this conductive backing, and these signals are capacitively coupled into the patient’s body through the ceramic discs. Conventional transducer designs include arrays of ceramic disks attached to a subject’s body via a conductive skin-contact layer such as a hydrogel. AC voltage is applied between a pair of transducers for an 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 at least another pair of transducers for another 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. BRIEF DESCRIPTION OF THE DRAWINGS [0003] FIG. 1 depicts an example method for determining transducer locations for delivering TTFields to the subject. [0004] FIGS. 2A-2E depict examples of various target volumes. [0005] FIG. 3 depicts an example apparatus to apply alternating electric fields to the subject’s body. [0006] FIGS. 4 A and 4B depict schematic views of exemplary designs of a transducer for applying alternating electric fields. [0007] FIG. 5 depicts an example placement of transducers on a subject’s head. [0008] FIG. 6 depicts an example computer apparatus. DESCRIPTION OF EMBODIMENTS [0009] This application describes exemplary techniques to computationally select and determine at least one transducer array layout for delivering TTFields on the subject. [0010] Traditionally in tumor treatment, radiation is applied to treat where a tumor is identified and located. Severe side effects may occur when applying the radiation to larger areas based on predictive spread. For example, the inherent toxicity of radiation treatment may cause side effects that may outweigh the benefits from treating a tumor. Further, the human body may also have a lifetime maximum limit to the effectiveness of radiation treatment. Moreover, applying radiation to a predictive area where the tumor may spread may reduce the effectiveness of subsequent treatment with radiation. [0011] As an alternative or supplemental treatment, TTFields may be introduced and delivered to the subject’s body, which may have less side effects and more flexibility in term of tailoring a tumor treatment plan. In general, in order to apply TTFields to the subject’s body, one or more pairs of transducers are positioned on the subject’s body. Generally, it is preferred that there are at least two pairs of transducers. Transducers used to apply TTFields to the subject’s body often include multiple electrode elements coupled together on a substrate. Determining the predictive spread of the tumor and a corresponding location where to place the transducers on the subject involves using very large data sets and computationally solving complex algorithms that can take a significant amount of time. [0012] The inventors discovered computational techniques to determine one or more predictive clinical target volumes for a tumor, wherein the predictive clinical target volume represents a predicted future location of the tumor in the subject. The treatment of the predicted future location of the tumor in the subject may reduce the likelihood of the tumor expanding and/or another tumor forming in the subject. The inventive techniques are particularly integrated into a practical application. With the inventive techniques, more locations on the subject can be involved in tumor treatment with less side effects compared to when using radiation alone. With the inventive techniques, more transducer locations may be determined much quicker than with conventional techniques. In addition, the inventive techniques allow flexible deployment and combination of tumor treatment methods and dosage use. [0013] FIG. 1 depicts an example computer-implemented method 100 for selecting at least one transducer array layout for delivering TTFields t