K Number
K232136
Date Cleared
2024-01-04

(170 days)

Product Code
Regulation Number
892.1750
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

syngo.CT Applications is a set of software applications for advanced visualization, measurement, and evaluation for specific body regions.

This software package is designed to support the radiologists and physicians from emergency medicine, specialty care, urgent care, and general practice e.g. in the:

  • · Evaluation of perfusion of organs and tumors and myocardial tissue perfusion
  • · Evaluation of bone structures and detection of bone lesions
  • · Evaluation of CT images of the heart
  • · Evaluation of the coronary lesions
  • · Evaluation of the mandible and maxilla
  • · Evaluation of dynamic vessels and extended phase handling

· Evaluation of the liver and its intrahepatic vessel structures to identify the vascular territories of sub-vessel systems in the liver

  • Evaluation of neurovascular structures
  • · Evaluation of the lung parenchyma
  • · Evaluation of non-enhanced Head CT images
  • · Evaluation of vascular lesions
Device Description

The syngo.CT Applications are syngo based post-processing software applications to be used for viewing and evaluating CT images provided by a CT diagnostic device and enabling structured evaluation of CT images.

The syngo.CT Applications is a combination of fourteen (14) medical devices which are handled as features / functionalities within syngo.CT Applications.

AI/ML Overview

The provided text is a 510(k) summary for the device "syngo.CT Applications." It describes the device, its indications for use, and a comparison to a predicate device. However, it does not explicitly detail the acceptance criteria for the device's performance nor does it present a study that proves the device meets specific performance metrics.

Instead, the document primarily focuses on:

  • Substantial Equivalence: Arguing that the new version of syngo.CT Applications is substantially equivalent to a previously cleared version and other reference devices.
  • Software Verification and Validation: Stating that V&V activities were performed and that the device conforms to special controls and standards.
  • Risk Analysis: Confirming risk analysis was completed and controls implemented.
  • Compliance with Standards: Listing recognized consensus standards the device meets.

Therefore, many of the requested details about acceptance criteria and a specific performance study are not available in the provided text.

Here's an attempt to answer based on the information available and what can be inferred:

Acceptance Criteria and Device Performance Study Information

Disclaimer: The provided document is a 510(k) summary, primarily focused on demonstrating substantial equivalence to a predicate device, rather than a detailed report of a performance study with specific acceptance criteria and results. Therefore, much of the requested information regarding specific quantitative acceptance criteria and the details of a primary performance study is not explicitly stated in the text. The document refers to "testing supports that all software specifications have met the acceptance criteria," but does not list these criteria or detailed results.


1. Table of Acceptance Criteria and Reported Device Performance

As mentioned above, specific quantitative acceptance criteria and their corresponding reported performance values are not detailed in the provided 510(k) summary. The document broadly states:

  • "The testing supports that all software specifications have met the acceptance criteria."
  • "The testing results support that all the software specifications have met the acceptance criteria."
  • "The result of all testing conducted was found acceptable to support the claim of substantial equivalence."

This indicates that internal acceptance criteria were established and met, but their specifics are not published here.


2. Sample Size Used for the Test Set and Data Provenance

The document does not specify the sample size used for any test set or the provenance (e.g., country of origin, retrospective/prospective) of data used for testing. It refers to "testing for verification and validation" but does not provide these details.


3. Number of Experts and Qualifications for Ground Truth

The document does not provide any information regarding the number of experts used to establish ground truth for a test set, nor their qualifications. Given the nature of the device (advanced visualization and measurement tools), it is likely that such evaluation involved clinical experts, but this is not stated.


4. Adjudication Method for the Test Set

The document does not specify any adjudication method (e.g., 2+1, 3+1, none) used for establishing ground truth or evaluating the test set.


5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study and Effect Size

The document does not mention that a Multi-Reader Multi-Case (MRMC) comparative effectiveness study was done, nor does it provide any effect size regarding human reader improvement with or without AI assistance. The submission focuses on software changes and bundling previously cleared functionalities.


6. Standalone (Algorithm Only) Performance Study

The document primarily describes a software application that assists radiologists and physicians. While it refers to "software verification and validation," it does not explicitly describe a standalone (algorithm only without human-in-the-loop performance) study for any specific AI or image processing component with quantitative results. The functions described are tools for evaluation by a human user.


7. Type of Ground Truth Used

The document does not explicitly state the type of ground truth used for any testing. Given the nature of medical imaging software, potential ground truth sources could include:

  • Expert consensus (e.g., radiologists, cardiologists)
  • Pathology reports
  • Clinical outcomes
  • Reference standards or phantoms
    However, the document does not specify which, if any, were used.

8. Sample Size for the Training Set

The document does not provide any information regarding the sample size used for the training set. This information is typically relevant for machine learning-based algorithms, and while syngo.CT Pulmo 3D mentions a "lung lobe segmentation algorithm," and syngo.CT CaScoring involves calculations, the document doesn't delve into the specifics of their underlying models or training.


9. How Ground Truth for the Training Set Was Established

The document does not provide any information on how ground truth for the training set was established.

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January 4, 2024

Image /page/0/Picture/1 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

Siemens Medical Solutions USA, Inc. Clayton Ginn Regulatory Affairs Professional 810 Innovation Drive KNOXVILLE, TN 37932

Re: K232136

Trade/Device Name: syngo.CT Applications Regulation Number: 21 CFR 892.1750 Regulation Name: Computed Tomography X-Ray System Regulatory Class: Class II Product Code: JAK Dated: December 13, 2023 Received: December 13, 2023

Dear Clayton Ginn:

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.

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).

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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.

For comprehensive regulatory information about mediation-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,

Image /page/1/Picture/6 description: The image shows the name "Gabriela M. Rodal -S" in a simple, sans-serif font. The text is arranged vertically, with "Gabriela M." on the first line and "Rodal -S" on the second line. The text is black against a white background.

Digitally signed by Gabriela M. Rodal -S for

Lu Jiang, Ph.D. Assistant Director DHT8B: Division of Radiologic Imaging Devices and Electronic Products 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) K232136

Device Name syngo.CT Applications

Indications for Use (Describe)

syngo.CT Applications is a set of software applications for advanced visualization, measurement, and evaluation for specific body regions.

This software package is designed to support the radiologists and physicians from emergency medicine, specialty care, urgent care, and general practice e.g. in the:

  • · Evaluation of perfusion of organs and tumors and myocardial tissue perfusion
  • · Evaluation of bone structures and detection of bone lesions
  • · Evaluation of CT images of the heart
  • · Evaluation of the coronary lesions
  • · Evaluation of the mandible and maxilla
  • · Evaluation of dynamic vessels and extended phase handling

· Evaluation of the liver and its intrahepatic vessel structures to identify the vascular territories of sub-vessel systems in the liver

  • Evaluation of neurovascular structures
  • · Evaluation of the lung parenchyma
  • · Evaluation of non-enhanced Head CT images
  • · Evaluation of vascular lesions
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)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

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Image /page/3/Picture/0 description: The image contains the logo for Siemens Healthineers. The word "SIEMENS" is in teal, and the word "Healthineers" is in orange. To the right of the word "Healthineers" is a graphic of orange dots.

510(k) Summary – K232136

1. Identification of the Submitter

Submitter / Primary Contact PersonClayton Ginn
Regulatory Affairs
clayton.ginn@siemens-healthineers.com
+1 (865) 898-2692
Secondary Contact PersonMonsuru (Kenny) Bello
Regulatory Affairs
monsuru.bello@siemens-healthineers.com
+1 (240) 601-3848
Submitter AddressSiemens Medical Solutions, Inc. USA
Molecular Imaging
810 Innovation Drive
Knoxville, TN 37932
Establishment Registration Number: 1034973
Manufacturing SiteSiemens Healthcare GmbH
Siemensstr 1 -or- Rittigfeld
Forchheim, Bavaria, DE 91301
Establishment Registration Number: 3004977335
Importer/DistributorSiemens Medical Solutions USA, Inc.
40 Liberty Boulevard
Malvern, PA 19355
Establishment Registration Number: 2240869

2. Device Name and Classification

Product Name:syngo.CT Applications
Propriety Trade Name:syngo.CT Applications
Regulation Name:Computed tomography x-ray system
Classification Name:System, X-ray, Tomography, Computed
Classification Panel:Radiology
CFR Section:21 CFR §892.1750
Device Class:Class II
Product Code:JAK

3. Predicate Devices

Primary Predicate Device:

Trade Name:syngo.CT Applications
510(k) Number:K220450
Clearance Date:03/07/2022
Regulation Name:Computed tomography x-ray system
Classification Name:System, X-ray, Tomography, Computed
Classification Panel:Radiology

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Image /page/4/Picture/0 description: The image shows the logo for Siemens Healthineers. The word "SIEMENS" is written in teal, and the word "Healthineers" is written in orange below it. To the right of the word "Healthineers" is a graphic of orange dots arranged in a circular pattern.

CFR Section: 21 CFR §892.1750 Device Class: Class II Product Code: JAK

Reference Devices

Trade Name:syngo.CT CaScoring
510(k) Number:K221219
Clearance Date:05/17/2022
Regulation Name:Computed tomography x-ray system
Classification Name:System, X-ray, Tomography, Computed
Classification Panel:Radiology
CFR Section:21 CFR §892.1750
Device Class:Class II
Product Code:JAK
Trade Name:syngo.CT Extended Functionality
510(k) Number:K203699
Clearance Date:04/30/2021
Regulation Name:Computed tomography x-ray system
Classification Name:System, X-ray, Tomography, Computed
Classification Panel:Radiology
CFR Section:21 CFR §892.1750
Device Class:Class II

JAK

4. Device Description

Product Code:

The syngo.CT Applications are syngo based post-processing software applications to be used for viewing and evaluating CT images provided by a CT diagnostic device and enabling structured evaluation of CT images.

The syngo.CT Applications is a combination of fourteen (14) medical devices which are handled as features / functionalities within syngo.CT Applications.

The table below shows the functionalities of syngo.CT Applications:

SingleApplicationFunctionality and description
syngo.CT BodyPerfusion• Evaluation of perfusion of organs and tumors.• Calculation blood flow, blood volume and permeability from sets of imagesreconstructed from dynamic CT data acquired after the injection of contrast media• Separate calculation of arterial and portal venous component of hepatic perfusion• Evaluation of regions of interest and visual inspection of time density curves• Deconvolution methods
SingleApplicationFunctionality and description
syngo.CT BoneReading• visualizations of spine and rib structures• multiplanar reconstruction (MPR) thin/thick, maximum intensity projection (MIP)thin/thick, inverted MIP thin/thick, volume rendering technique (VRT)• geometric measurement tools (distance line, polyline, marker, arrow, angle)• HU measurement tools (Pixel lens, ROI circle, ROI polygonal, ROI freehand, VOIsphere)• curved MPR visualization (unfolded ribs and spine views), crosssection MPRs• tools for creation and editing of anatomical centerline paths• tools for creation and editing of anatomical labels
syngo.CTCardiacFunction• Evaluation of CT images of the heart.• Digital image processing and visualization tools (2D, 3D and 4D display of dynamic data),• Evaluation tools (structural and functional analysis of heart chambers and valves, and analysis of myocardial tissue)• Reporting tools
syngo.CTCaScoring• Loading of a series of appropriate CT- or MR-Images from the patient database• Browsing, selecting, and displaying images for searching calcium regions/lesions• Interactive definition of ROIs and assignment of the four major coronary arteries (LM, LAD, CX and RCA) to the lesions• Calculation and display of the 2D-Agatston score/factor or other metric on the defined ROIs• Interactive definition of ROIs (for example noise) to disqualify the region from participation in the score• Displaying the score in form of result tables/reports on paper and/or film• Pan and Zoom functionality/windowing• Reformatting• Comparison of score to cited literature
syngo.CTCoronaryAnalysis• Evaluating of cardiac CT angiography (CTA) volume data sets• Combination of digital image processing and visualization tools (multiplanar reconstruction (MPR) thin/thick, maximum intensity projection (MIP) thin/thick, inverted MIP thin/thick, volume rendering technique (VRT), curved planar reformation (CPR))• Evaluation tools (coronary vessel centerline calculation, stenosis calculation and plaque analysis) and reporting tools (lesion location, lesion characteristics and key images),• Designed to support the physician in confirming the presence or absence of physician-identified coronary lesions and evaluation, documentation and follow-up of any such lesion These visualization/evaluation tools allow for characterization (geometry (length, lumen diameter, cross section area, stenos is grade) and appearance (HU values)) of coronary lesions and lesion size over time, helping the physician to assess the changes in their growth. It is also designed to help the physician classify conspicuous regions of tissue
SingleApplicationFunctionality and description
syngo.CTDental• Basic reading tools (multiplanar reconstruction (MPR), maximum intensity projection(MIP), volume rendering technique (VRT), minimal intensity projection (MinIP)• Basic geometric measurement tools (distance line, polyline, marker, arrow, angle)• Basic HU measurement tools (Pixel lens, ROI Circle, ROI polygonal, ROI freehand, VOIsphere, VOI freehand)• Dedicated dental visualization tools (Dental panoramic views (curved MPRs) anddental paraxial views (cross-section MPRs) that are calculated based on a manuallydefined centerline)• Tool to manually outline the mandibular canal• Tool that allows paraxial and panoramic result images to be saved as dental rangeseries.• True Size (1:1) printing of panoramic and paraxial images to allow anatomy to beprinted in its actual size on the film sheet.
syngo.CTDynamicAngio• Visualization of flow of contrast from the arteries to the veins with contrast enhancedCT images• Supports in the evaluation of regions of interest, the visual inspection of timeattenuation curves, and the creation of specific CT volumes, for example, arterial orvenous phase.
syngo.CT LiverAnalysis• Evaluation of the liver volume and examination of the vessels of the liver• Computation and manual correction of liver volumes• Computation and manual correction of tumor volumes and extent• Computation and manual correction of liver vessel tree structure• Computation of territories based on vessel branches• Tumor position in relation to vessels (i.e., 3D visualization of liver, tumor, and vessels)• Manual definition of separation plane proposals• Computation of volume of liver parts• Combination of information from different CT and MR phase volumes
syngo.CTMyocardPerfusion• Evaluation of the perfusion of the myocardium• Calculation of blood flow, blood volume, and other hemodynamic parameters fromsets of images reconstructed from dynamic CT data acquired after the injection ofcontrast media• Evaluation of regions of interest and the visual inspection of time attenuation curves
syngo.CTNeuro DSA• Removing of bone structures from CT Angiography (CTA) data sets of the cerebralvasculature• Bone removal is based on a bone mask created from an additional non enhanced CT(NECT) scan that was three-dimensionally registered to the CTA data set
SingleApplicationFunctionality and description
syngo.CTNeuroPerfusion• The syngo.CT Neuro Perfusion software package is designed to evaluate areas ofbrain perfusion. The software processes images or volumes that were reconstructedfrom continuously acquired CT data after the injection of contrast media.• Generation of the following result volumes: Cerebral blood flow (CBF), Cerebral bloodvolume (CBV), Local bolus timing (time to start (TTS), time to peak (TTP), time to drain(TTD)), Mean transit time (MTT), Transit time to the center of the IRF (TMax), Flowextraction product (permeability), Temporal MIP, Temporal Average, BaselineVolume , Modified dynamic input data• The software allows the calculation of mirrored regions of interest and the visualinspection of time attenuation curves.• One clinical application is to visualize the apparent blood perfusion and to calculateHypoperfused Area and Mismatch Ratio in the brain tissue affected by acute stroke.• Areas of decreased perfusion appear as areas of changed signal intensity: Lowersignal, intensity for CBF and CBV, Higher signal intensity for TTP, TTD, MTT, and TMax• A second application is to visualize blood brain barrier disturbances by modelingextra-vascular leakage of blood into the interstitial space. This additional capabilitymay improve the differential diagnosis of brain tumors and may be helpful in therapymonitoring.
syngo.CTPulmo 3D• syngo.CT Pulmo 3D analyses the lung, either completely or in parts, identifying areaswith lower or higher Hounsfield values in comparison to a predefined threshold.These areas are evaluated using statistical methods such as histograms andpercentiles.• Examination of the lung parenchyma and the airways of the lung• Evaluation Tools (computation of lung volumes, display of statistics related to thelung, setting of markers, airway measurements)
syngo.CT SkullUnfolding• This software provides advanced visualization of the skull and brain surface for easymanual identification, marking and reporting of pathologies such as skull fracturesand hematomas.
syngo.CTVascularAnalysis• syngo.CT Vascular Analysis is an image analysis software package for evaluatingenhanced CT images.• Visualization tools (multiplanar reconstruction (MPR) thin/thick, maximum intensityprojection (MIP) thin/thick, inverted MIP thin/thick, volume rendering technique(VRT), curved planar reformation (CPR), processing tools (bone removal (based bothon single energy and Dual Energy), table removal)• Evaluation tools (vessel centerline calculation, lumen calculation, stenosis calculation)• Reporting tools (lesion location, lesion characteristics and key images),• the software package is designed to support the physician in confirming the presenceor absence of physician-identified lesions in blood vessels and evaluation,documentation and follow-up of any such lesion. Thesevisualization/processing/evaluation tools allow for characterization (geometry(length, lumen diameter, cross section area, stenosis grade) and appearance (HUvalues)) of vascular lesions and lesion size over time, helping the physician to assessthe changes in their growth. It is also designed to help the physician classifyconspicuous regions of tissue.

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Image /page/7/Picture/0 description: The image shows the Siemens Healthineers logo. The word "SIEMENS" is in teal, and the word "Healthineers" is in orange. To the right of the word "Healthineers" is a graphic of orange dots.

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Image /page/8/Picture/0 description: The image shows the Siemens Healthineers logo. The word "SIEMENS" is in teal, and the word "Healthineers" is in orange. To the right of the words is a graphic of orange dots in a circular pattern. The logo is simple and modern.

This subject device which is versioned as SOMARIS/8 VB80 includes the f

  • syngo.CT CaScoring Added to the subject device as a fourteenth application and extended the . export function to include a DICOM Structured Report.
  • . syngo.CT Pulmo 3D – Added an interface to syngo.CT Lung CAD (latest clearance: K203258, K231157), and integrated the lung lobe segmentation algorithm from syngo.CT Extended Functionality (K203699).

5. Indications for Use

syngo.CT Applications is a set of software applications for advanced visualization, measurement, and evaluation for specific body regions.

This software package is designed to support the radiologists and physicians from emergency medicine, specialty care, urgent care, and general practice e.g. in the:

  • Evaluation of perfusion of organs and tumors and myocardial tissue perfusion
  • . Evaluation of bone structures and detection of bone lesions
  • Evaluation of CT images of the heart
  • Evaluation of the coronary lesions
  • Evaluation of the mandible and maxilla
  • Evaluation of dynamic vessels and extended phase handling
  • . Evaluation of the liver and its intrahepatic vessel structures to identify the vascular territories of sub-vessel systems in the liver
  • Evaluation of neurovascular structures
  • . Evaluation of the lung parenchyma
  • Evaluation of non-enhanced Head CT images
  • Evaluation of vascular lesions

6. Indications for Use Comparison to the Predicate Device

There is no change to the indications for use. Each bulleted function in the indications for use relates to one of the now bundled applications. The new application syngo.CT CaScoring falls under the phrase 'Evaluation of coronary lesions'.

FunctionRelated Application
Evaluation of perfusion of organs and tumors and myocardialtissue perfusionsyngo.CT Body Perfusionsyngo.CT Myocardial Perfusion
Evaluation of bone structures and detection of bone lesionssyngo.CT Bone Readingsyngo.CT Skull Unfolding
Evaluation of CT images of the heartsyngo.CT Cardiac Function
Evaluation of the coronary lesionssyngo.CT Coronary Analysissyngo.CT CaScoring
Evaluation of the mandible and maxillasyngo.CT Dental
Evaluation of dynamic vessels and extended phase handlingsyngo.CT Dynamic Angio
Evaluation of the liver and its intrahepatic vessel structures toidentify the vascular territories of sub-vessel systems in the liversyngo.CT Liver Analysis

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Image /page/9/Picture/0 description: The image shows the logo for Siemens Healthineers. The word "SIEMENS" is in teal, and the word "Healthineers" is in orange. To the right of the word "Healthineers" is a series of orange dots that are arranged in a circular pattern.

Evaluation of neurovascular structuressyngo.CT Neuro Perfusion
Evaluation of the lung parenchymasyngo.CT Pulmo 3D
Evaluation of non-enhanced Head CT imagessyngo.CT Neuro DSA
Evaluation of vascular lesionssyngo.CT Vascular Analysis

7. Comparison of Technological Characteristics with the Predicate Device

The subject device is a combination of the fourteen (14) medical devices. The main functionalities of the predicate device is unchanged for syngo.CT Applications SOMARIS/VB70 except the minor changes within syngo.CT Pulmo 3D. For this subject device, the legally marketed syngo.CT CaScoring application was bundled to the subject device and the export function was extended.

Subject Devicesyngo.CT Applications(SOMARIS/8 VB80)Predicate Devicesyngo.CT Applications(SOMARIS/8 VB70)Comparison Result
Built-in applications in the subject device "syngo.CT Applications"
syngo.CT Body Perfusionsyngo.CT Body PerfusionSame
syngo.CT Bone Readingsyngo.CT Bone ReadingSame
syngo.CT Cardiac Functionsyngo.CT Cardiac FunctionSame
syngo.CT Coronary Analysissyngo.CT Coronary AnalysisSame
syngo.CT Dynamic Angiosyngo.CT Dynamic AngioSame
syngo.CT Dentalsyngo.CT DentalSame
syngo.CT Liver Analysissyngo.CT Liver AnalysisSame
syngo.CT Myocardial Perfusionsyngo.CT Myocardial PerfusionSame
syngo.CT Neuro DSAsyngo.CT Neuro DSASame
syngo.CT Neuro Perfusionsyngo.CT Neuro PerfusionSame
syngo.CT Pulmo 3Dsyngo.CT Pulmo 3DExtendedImplementation of a software interfacewhich provided a connection to theexternal medical device syngo.CT LungCAD with separate clearance.Additionally, integration of the lung lobesegmentation feature which remainsunchanged as compared to the referencedevice syngo.CT Extended Functionality(K203699).
syngo.CT Skull Unfoldingsyngo.CT Skull UnfoldingSame
syngo.CT Vascular Analysissyngo.CT Vascular AnalysisSame

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Image /page/10/Picture/0 description: The image contains the logo for Siemens Healthineers. The word "SIEMENS" is written in teal, and the word "Healthineers" is written in orange below it. To the right of the words is a graphic of orange dots.

Subject Devicesyngo.CT Applications(SOMARIS/8 VB80)Predicate Devicesyngo.CT Applications(SOMARIS/8 VB70)Comparison Result
syngo.CT CaScoringNot available in the predicate devicebut former separately cleared assyngo.CT CaScoring (K221219,clearance date 05/17/2022)ExtendedThis medical device has been included tothe software package syngo.CTApplications with no significant changesrespectively changes to the clinicalfunctionality of syngo.CT CaScoring. Thisapplication has been formerly clearedwith K221219. Furthermore, the exportfunction has been extended.

8. Performance Data

The following performance data were provided in support of the substantial equivalence determination.

Software Verification and Validation

Software Documentation for a Moderate Level of Concern software per FDA's Guidance Document "Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices" issued on May 11, 2005 is also included as part of this submission. The performance data demonstrates continued conformance with special controls for medical devices containing software. The Risk Analysis was completed, and risk control implemented to mitigate identified hazards. The testing supports that all software specifications have met the acceptance criteria. Testing for verification and validation support the claim of substantial equivalence.

Risk Analysis

The risk analysis was completed, and risk control implemented to mitigate identified hazards. The testing results support that all the software specifications have met the acceptance criteria. Testing for verification and validation of the device was found acceptable to support the claims of substantial equivalence.

Siemens hereby certifies that synqo.CT Applications meets the following FDA Recognized Consensus standards listed below:

RecognitionNumberProductAreaTitle of StandardDate ofRecognitionStandardsDevelopmentOrganization
12-349RadiologyDigital Imaging and Communications in Medicine(DICOM) Set; PS 3.1 - 3.20 2022d12/19/2022NEMA
13-79SoftwareMedical Device Software – Software Life CycleProcesses; 62304:2006 (1st Edition)/A1:201601/14/2019AAMI, ANSI,IEC
5-125Software/InformaticsMedical devices – Application of risk management tomedical devices; 14971 Third Edition 2019-1212/23/2019ISO

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Image /page/11/Picture/0 description: The image contains the logo for Siemens Healthineers. The word "SIEMENS" is written in teal, and the word "Healthineers" is written in orange. To the right of the word "Healthineers" is a graphic of orange dots.

5-129General I(QS/RM)Medical devices - Part 1: Application of usabilityengineering to medical devices62366-1:2015+AMD1:202007/06/2020AAMI, ANSI,IEC
5-134General(QS/RM)Medical devices - Symbols to be used with medicaldevice labels, labelling, and information to besupplied - Part 1: General requirementsISO 15223-1 Fourth edition 2021-0712/20/2021ISO

9. Conclusion

The fundamental scientific technology and technological characteristics are the same as the predicate device and reference device. The built-in applications in the subject device remain unchanged as the built-in ones in the predicate device except the application syngo.CT Pulmo 3D which includes the changes as shown in the comparison table. The additional bundling of syngo.CT CaScoring to the subject device and the minor improvements and enhancements do not raise questions of safety and efficacy since the changes do not introduce any new clinical algorithms/features and they do not change the performance of subject device significantly.

The result of all testing conducted was found acceptable to support the claim of substantial equivalence. The comparison of technological characteristics and software validation demonstrates that the subject device is as safe and effective when compared to the predicate device that is currently marketed for the same intended use.

For the subject device, syngo.CT Applications, Siemens used the same testing with the same workflows as used to clear the predicate devices. Siemens considers synqo.CT Applications to be as safe, as effective and with performance substantially equivalent to the commercially available predicate device.

Therefore, Siemens believes that the subject device, the syngo.CT Applications does not raise new questions of safety and effectiveness and is substantially equivalent to the predicate device.

§ 892.1750 Computed tomography x-ray system.

(a)
Identification. A computed tomography x-ray system is a diagnostic x-ray system intended to produce cross-sectional images of the body by computer reconstruction of x-ray transmission data from the same axial plane taken at different angles. This generic type of device may include signal analysis and display equipment, patient and equipment supports, component parts, and accessories.(b)
Classification. Class II.