(130 days)
Veuron-Brain-pAb3 is software for the registration, fusion, display, and analysis of medical images from multiple modalities including MRI and PET. The software aids clinicians in the assessment and quantification of pathologies from PET Amyloid scans of the human brain. It enables anatomic analysis and visualization of amyloid protein concentration through the calculation of standard uptake volume ratio (SUVR) within target reqions of interest and comparison to those within the reference regions. The software is deployed via medical imaging workplaces and is organized as a series of workflows which are specific to use with radio-tracer and disease combinations.
The Veuron-Brain-pAb3 is a standalone software for quantitative analysis of the PET amyloid by automatically calculating the "Standardized Uptake Value Ratio (SUVR)". The calculated result is only used as a reference to support the accuracy of the medical professional's diagnosis of dementia in patients. It also helps with accurate visual interpretation through visualization functions. Various PET amyloid images can be processed by using diverse options provided for users to choose in the image process.
The provided text describes the acceptance criteria and the study that proves the device meets those criteria for the Veuron-Brain-pAb3, a medical imaging software.
1. A table of acceptance criteria and the reported device performance:
The document doesn't provide explicit acceptance criteria in a quantitative format (e.g., minimum accuracy percentages, SUVR ranges) for the Veuron-Brain-pAb3. Instead, it states that "Software verification and validation was performed to demonstrate the new functions perform as intended." and "The testing results support that all the system requirements have met their acceptance criteria and are adequate for its intended use."
However, the key functions that define the device's performance, as outlined in the "Summary of Technological Characteristics" and "Device Description," are:
- Automatic calculation of Standardized Uptake Value Ratio (SUVR) within target regions of interest and comparison to reference regions.
- Anatomic analysis and visualization of amyloid protein concentration.
- Registration, fusion, and display of medical images (MRI and PET).
- Accurate visual interpretation through visualization functions.
The document implicitly states that these functions perform as intended, which serves as the "reported device performance" meeting the unspecified acceptance criteria.
2. Sample size used for the test set and the data provenance:
The document does not explicitly state the sample size used for the test set. However, it mentions under 'Segmentation Algorithm' that the CNN model was "trained [on] 3D brain MR images were collected from one domestic institution." This suggests the data used for testing (and training) was from a single domestic institution. It doesn't specify if the data was retrospective or prospective, but given it's part of a model training and validation process, it's highly likely to be retrospective.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:
The document does not specify the number or qualifications of experts used to establish the ground truth for the test set. The ground truth for the segmentation algorithm appears to be implicitly derived from the "3D brain MR images collected from one domestic institution" used for training the CNN model, meaning the "truths" would be the labeled segmentations used to train the model. Given the device's function is quantitative analysis (SUVR calculation), the ground truth for the SUVR calculation itself would be based on the established methodology of SUVR calculation rather than expert annotation for each case.
4. Adjudication method for the test set:
The document does not describe any adjudication method for the test set.
5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, if so, what was the effect size of how much human readers improve with AI vs without AI assistance:
No. The document explicitly states: "No clinical testing was conducted." Therefore, an MRMC comparative effectiveness study was not performed.
6. If a standalone (i.e. algorithm only without human-in-the loop performance) was done:
Yes, implicitly. The device is described as "standalone software for quantitative analysis of the PET amyloid by automatically calculating the 'Standardized Uptake Value Ratio (SUVR)'." The "Non-Clinical Performance Testing" section mentions "Software verification and validation was performed to demonstrate the new functions perform as intended," which would involve evaluating the algorithm's performance in isolation. While the results are not quantitatively detailed, the device's core function is an automated calculation, suggesting standalone performance was assessed.
7. The type of ground truth used:
The type of ground truth for the core SUVR calculation is methodology-based (the calculation itself is a defined process). For the segmentation algorithm, the ground truth would be expert-annotated segmentations of brain MR images, used for training the CNN model.
8. The sample size for the training set:
The document does not specify the exact sample size for the training set, only stating that the CNN model for segmentation was "trained [on] 3D brain MR images were collected from one domestic institution."
9. How the ground truth for the training set was established:
The ground truth for the CNN model used for segmentation was established through the collection of "3D brain MR images were collected from one domestic institution" that were used to train the model. This implies that these images likely came with pre-existing or expert-derived segmentations necessary for supervised learning. For the SUVR calculation itself, the ground truth is inherently defined by the mathematical formula and anatomical regions used in its computation.
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October 13, 2023
Heuron Co., Ltd. % John J. Smith, M.D., J.D. Partner Hogan Lovells US LLP Columbia Square 555 Thirteenth Street NW Washington, District of Columbia 20004
Re: K231642
Trade/Device Name: Veuron-Brain-pAb3 Regulation Number: 21 CFR 892.2050 Regulation Name: Medical Image Management And Processing System Regulatory Class: Class II Product Code: LLZ Dated: September 13, 2023 Received: September 13, 2023
Dear John Smith:
We have reviewed your section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (the Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database available at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.
If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.
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Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device" (https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).
Your device is also subject to, among other requirements, the Quality System (QS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30. Design controls; 21 CFR 820.90. Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review, the QS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).
Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting of medical device-related adverse events) (21 CFR Part 803) for devices or postmarketing safety reporting (21 CFR Part 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.
Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.
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For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).
Sincerely,
D. Rayfield
Daniel M. Krainak, Ph.D. Assistant Director DHT8C: Division of Radiological Imaging and Radiation Therapy Devices OHT8: Office of Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health
Enclosure
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Indications for Use
510(k) Number (if known) K231642
Device Name Veuron-Brain-pAb3
Indications for Use (Describe)
Veuron-Brain-pAb3 is software for the registration, fusion, display, and analysis of medical images from multiple modalities including MRI and PET. The software aids clinicians in the assessment and quantification of pathologies from PET Amyloid scans of the human brain. It enables anatomic analysis and visualization of amyloid protein concentration through the calculation of standard uptake volume ratio (SUVR) within target reqions of interest and comparison to those within the reference regions. The software is deployed via medical imaging workplaces and is organized as a series of workflows which are specific to use with radio-tracer and disease combinations.
| Type of Use (Select one or both, as applicable) |
|---|
| ☒ Prescription Use (Part 21 CFR 801 Subpart D) |
— Over-The-Counter Use (21 CFR 801 Subpart C)
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510(k) SUMMARY Heuron Co., Ltd.'s Veuron-Brain-pAb3
Submitter Information Company Name: Heuron Co., Ltd. Address:10F, C, 150, Yeongdeungpo-ro, Yeongdeungpo-gu, Seoul, 07292, Republic of Korea
Contact Person: John J. Smith, M.D., J.D. Phone: +1 202 637 3638 Facsimile: +1 202 637 5910 Date Prepared: September 5, 2023
Name of Device: Veuron-Brain-pAb3 Common or Usual Name: Medical Imaging Software Classification Name: System, Image Processing, Radiological Regulatory Class: 21 CFR 892.2050 Product Code: LLZ
Predicate Device
Manufacturer name: Heuron Co., Ltd. Device's trade name: Veuron-Brain-pAb2 510(K) number: K213801 Regulatory Class: 21 CFR 892.2050 Product Code: LLZ
Device Description
The Veuron-Brain-pAb3 is a standalone software for quantitative analysis of the PET amyloid by automatically calculating the "Standardized Uptake Value Ratio (SUVR)". The calculated result is only used as a reference to support the accuracy of the medical professional's diagnosis of dementia in patients. It also helps with accurate visual interpretation through visualization functions. Various PET amyloid images can be processed by using diverse options provided for users to choose in the image process.
Intended Use / Indications for Use
The Veuron-Brain-pAb3 is a software for the registration, display and analysis of medical images from multiple modalities including MRI and PET. The software aids clinicians in the assessment and quantification of pathologies from PET amyloid scans of the human brain. It enables automatic analysis and visualization of amyloid concentration through the calculation of standard uptake value ratio (SUVR) within target regions of interest and comparison to those within the reference regions. The software is deployed via medical imaging workplace and is organized as a series of workflows which are specific to use with radio tracer and disease combinations.
Summary of Technological Characteristics
Image load and SUVR calculation is the technological principle for both the subject and predicate devices. Both devices load the MR and PET images, and calculate SUVR for the brain. At a high level, the subject and predicate devices are based on the following same technological elements:
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- Image load ●
- Overlay .
- SUVR calculation ●
- Report .
The following technological differences exist between the subject and predicate devices:
- . Addition of a worklist. Veuron-Brain-pAb3 includes a worklist showing the user of the list of patients.
- . Addition of a tracer option. With Veuron-Brain-pAb3, users can select the tracer for beta amyloid. By providing an option (reference region) for tracer, helps users identify appropriate brain regions for analysis.
| Subject device | Predicate device (K213801) | |
|---|---|---|
| Device name | Veuron-Brain-pAb3 | Veuron-Brain-pAb2 |
| Manufacturer | Heuron Co., Ltd. | Heuron Co., Ltd. |
| Product code | LLZ | LLZ |
| Indications for use | The Veuron-Brain-pAb3 is software forthe registration, fusion, display, andanalysis of medical images from multiplemodalities including MRI and PET. Thesoftware aids clinicians in theassessment and quantification ofpathologies from PET Amyloid scans ofthe human brain. It enables anatomicanalysis and visualization of amyloidprotein concentration through thecalculation of standard uptake volumeratio (SUVR) within target regions ofinterest and comparison to those withinthe reference regions. The software isdeployed via medical imagingworkplaces and is organized as a seriesof workflows which are specific to usewith radio-tracer and diseasecombinations. | The Veuron-Brain-pAb2 is softwarefor the registration, fusion, display,and analysis of medical images frommultiple modalities including MRIand PET. The software aidsclinicians in the assessment andquantification of pathologies fromPET Amyloid scans of the humanbrain. It enables automatic analysisand visualization of amyloid proteinconcentration through the calculationof standard uptake volume ratio(SUVR) within target regions ofinterest and comparison to thosewithin the reference regions. Thesoftware is deployed via medicalimaging workplaces and is organizedas a series of workflows which arespecific to use with radiotracer anddisease combinations. |
| Target anatomical site | Brain | Brain |
| Where used | Hospital | Hospital |
| Design features | Import DICOM dataPerform automatic post-processingProvide the user confirmationExport the resulting data through anetwork or USB | Import DICOM data.Perform automatic post-processing.Provide the user confirmationExport the resulting data through anetwork or USB |
| Physical characteristics | Software package | Software package |
| Subject device | Predicate device (K213801) | |
| Operates on off-the-shelf hardware(multiple vendors) | Operates on off-the-shelf hardware(multiple vendors) | |
| Operating system | Server: Linux (Ubuntu 18.04 LTS orhigher)Client: Windows 10 or higher | Server: Ubuntu 16.04 LTS or higherClient: Windows 10, 64-bit |
| Standards | ISO 14971IEC 62304IEC 62366 | ISO 14971IEC 62304IEC 62366 |
| Software verification and validation | Tested in accordance with verificationand validation process and planning. Thetesting results support that all the systemrequirements have met their acceptancecriteria and are adequate for its intendeduse. | Tested in accordance withverification and validation processesand planning. The testing resultssupport that all the systemrequirements have met theiracceptance criteria and areadequate for its intended use. |
| Compatible input data format andmodality | DICOM & NIfTIPET, MRI | DICOM & NIfTIPET, MRI |
| Input patient data | Manual through keyboard/mouse | Manual through keyboard/mouse |
| Output patient data | Picture: PNGReport: PNG, csv | Picture: PNGReport: csv |
| Study list functionality | SearchImportingExporting | SearchImportingExporting |
| Worklist | Yes | No |
| Yes, can select the tracer for beta amyloid | No, cannot select the tracer for betaamyloid | |
| Tracer option | Tracer list• 18F-Flutemetamol (FMM)• 18F-Florbetapir (FBP)• 18F-Florbetaben (FBB) | |
| Segmentation Algorithm | • Calculate the volume by using aConvolutional Neural Network(CNN) model.• CNN model has trained 3D brain MRimages were collected from onedomestic institution | • Calculate the volume by using aConvolutional Neural Network(CNN) model.• CNN model has trained 3Dbrain MR images were collectedfrom one domestic institution. |
A table comparing the key features of the subject and predicate devices is provided below.
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Non-Clinical Performance Testing
Software verification and validation was performed to demonstrate the new functions perform as intended. No clinical testing was conducted.
Conclusions
The Veuron-Brain-pAb3 is as safe and effective as the Veuron-Brain-pAb2. The Veuron-Brain-pAb3 has the same intended uses and indications, it has similar technological characteristics, and principles of operation as its predicate device. In addition, the minor technological differences between the Veuron-Brain-pAb3 and its predicate devices raise no new issues of safety or effectiveness.
§ 892.2050 Medical image management and processing system.
(a)
Identification. A medical image management and processing system is a device that provides one or more capabilities relating to the review and digital processing of medical images for the purposes of interpretation by a trained practitioner of disease detection, diagnosis, or patient management. The software components may provide advanced or complex image processing functions for image manipulation, enhancement, or quantification that are intended for use in the interpretation and analysis of medical images. Advanced image manipulation functions may include image segmentation, multimodality image registration, or 3D visualization. Complex quantitative functions may include semi-automated measurements or time-series measurements.(b)
Classification. Class II (special controls; voluntary standards—Digital Imaging and Communications in Medicine (DICOM) Std., Joint Photographic Experts Group (JPEG) Std., Society of Motion Picture and Television Engineers (SMPTE) Test Pattern).