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Treatment planning for ultrasound phased arrays suggests a strategy for hyperthermia therapy which satisfies therapeutic conditions at the target and spares other sensitive anatomical structures. To predict both desirable and harmful interactions between ultrasound and important structures such as the tumor, bones, and air pockets, a hyperthermia treatment planning system has been developed for ultrasound phased arrays. This collection of treatment planning routines consists of geometric and thermal optimization procedures specific to ultrasound phased arrays, where geometric treatment planning, combined with thermal treatment planning and three-dimensional visualization, provides essential information for the optimization of individual patient treatments. A patient image data set for cancer of the prostate, a difficult target situated in the midst of multiple pelvic bone obstructions, illustrates the geometric treatment planning algorithm and other tools for treatment analysis. The results indicate that the analysis of complex three-dimensional relationships between the applicator, anatomical structures, and incident fields provides an important means of predicting treatment limiting conditions, thereby allowing the hyperthermia applicator to electronically adapt to individual patients and specific sites.