K Number
K050458
Device Name
TSX-201A AQUILION LB CT SCANNER
Date Cleared
2005-03-10

(15 days)

Product Code
Regulation Number
892.1750
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
X-ray imaging of whole body - Computerized Tomography Including: Axial Volumetric (Helical) CT Fluoroscopy
Device Description
The Aquilion LB is a multi-slice helical CT system, consisting of a gantry, patient couch and console. The system generates up to 32 axial slices per second using a selectable slice-thickness multi-row detector.
More Information

No
The summary describes a standard multi-slice helical CT system with no mention of AI or ML capabilities in the device description, intended use, or any other section.

No.
The device is described as an X-ray imaging system (CT scanner) used for diagnostic purposes, not for treating diseases or conditions.

Yes
The device is a CT system, which is used for X-ray imaging of the whole body. Imaging modalities like CT are inherently diagnostic, as they provide visual information of internal structures to help identify and characterize diseases or injuries. While the description doesn't explicitly state "diagnostic," the nature of the device (imaging modality for whole body) implies a diagnostic purpose.

No

The device description explicitly states it is a "multi-slice helical CT system, consisting of a gantry, patient couch and console," which are hardware components.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections. They are used to provide information for diagnosis, monitoring, or screening.
  • Device Function: The provided description clearly states that the device is an X-ray imaging system (Computerized Tomography - CT). It uses X-ray transmission data to create images of the whole body. This is an in vivo diagnostic method, meaning it is performed on the living body, not on samples taken from the body.

Therefore, based on the intended use and device description, the Aquilion LB is a medical imaging device, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

This device is designed to produce cross-sectional images of a human body by reconstruction of xray transmission data from the same axial plane taken at different angles. These images have been proven to be clinically useful in the diagnosis of spine and head injuries, intracranial tumors, blood clots in the brain, eye trauma, soft tissue lesions in the extremities, gastrointestinal lesions, abdominal and pelvic malignancies, and hepatic metastases. CT is also used to evaluate intestinal obstructions, assess intra-abdominal abnormalities and to examine musculoskeletal degeneration. This device employs no intended uses that are not in cleared devices already found in the marketplace.

X-ray imaging of whole body - Computerized Tomography Including: Axial Volumetric (Helical) CT Fluoroscopy

Product codes

90JAK

Device Description

The Aquilion LB is a multi-slice helical CT system, consisting of a gantry, patient couch and console. The system generates up to 32 axial slices per second using a selectable slice-thickness multi-row detector.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

X-ray transmission data

Anatomical Site

Whole body

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Not Found

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

TSX-101A, Aquilion MS-16 [K022050]

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 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.

0

Image /page/0/Picture/0 description: The image shows the text "K050458" written in a handwritten style. The text is oriented diagonally, sloping upwards from left to right. The characters are bold and slightly distorted, giving them a unique, informal appearance.

510(k) Summary

MAR 1 0 2005

Date:January
Submitter's Name:Toshiba America Medical Systems, Inc.
Submitter's Address:P.O. Box 2068, 2441 Michelle Drive,
Tustin, CA 92781-2068
Submitter's Contact:Paul Biggins, Senior Manager Regulatory Affairs
(714)730-5000
Establishment Registration
Number:2020563
Device Proprietary Name:TSX-201A, Aquilion LB CT Scanner
Common Name:Scanner, Computed Tomography, X-Ray
[Fed. Reg. No. 892.1750, Pro. Code: 90JAK]
Regulatory Class:II (per 21 CFR 892.1750)
Performance Standard:21 CFR Subchapter J,
Federal Diagnostic X-ray Equipment Standard
Predicate Device(s):TSX-101A, Aquilion MS-16 [K022050]
Reason For SubmissionModification of cleared device

Description of this Device:

The Aquilion LB is a multi-slice helical CT system, consisting of a gantry, patient couch and console. The system generates up to 32 axial slices per second using a selectable slice-thickness multi-row detector.

Summary of Intended Uses:

This device is designed to produce cross-sectional images of a human body by reconstruction of xray transmission data from the same axial plane taken at different angles. These images have been proven to be clinically useful in the diagnosis of spine and head injuries, intracranial tumors, blood clots in the brain, eye trauma, soft tissue lesions in the extremities, gastrointestinal lesions, abdominal and pelvic malignancies, and hepatic metastases. CT is also used to evaluate intestinal obstructions, assess intra-abdominal abnormalities and to examine musculoskeletal degeneration. This device employs no intended uses that are not in cleared devices already found in the marketplace.

Technological Characteristics:

This device employs the same technological characteristics as the predicate device, differing only in the specifics of subassembly component composition. Both of these systems employ the use of

1

high frequency x-ray controllers to generate x-radiation from the x-ray tube. The x-ray transmission data is detected by the x-ray detector and is reconstructed by the computer. This device produces two-dimensional and three-dimensional, black and white images that can be filmed or electronically stored for future review.

Safety and Effectiveness Concerns:

This device is designed and manufactured under the Quality System Regulations as outlined in 21 CFR § 820. All requirements of the Federal Diagnostic Equipment Standard, as outlined in 21 CFR § 1020.30 and 1020.33, will be met and reported via a supplement to the initial report for the predicate device. Additionally this system is in conformance with the applicable parts of the IEC-60601 - Medical Device Safety standards.

Substantial Equivalence:

Based upon the above considerations TAMS believes that Aquilion LB CT scanner is substantially equivalent to the predicate Aquilion MS-16 CT scanner [K022050].

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Image /page/2/Picture/1 description: The image shows a circular logo with a stylized bird in the center. The bird is composed of three curved lines that suggest wings and a body. The logo is encircled by text that reads 'DEPARTMENT OF HEALTH & HUMAN SERVICES' in a circular arrangement around the bird. The text is in all capital letters and is smaller than the central bird image.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAR 1 0 2005

Toshiba America Medical Systems, Inc. c/o Mr. Mark Job Third Party Official Regulatory Technology Services LLC 1394 25th Street NW BUFFALO MN 55313

Re: K050458

Trade/Device Name: Aquilion LB CT Scanner TSX-201A Regulation Number: 21 CFR §892.1750 Regulation Name: Computed tomography x-ray system Regulatory Class: II Product Code: 90 JAK Dated: February 18, 2005 Received: February 23, 2005

Dear Mr. Job:

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 (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. 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.

If your device is classified (see above) into either class II (Special Controls) or class III (Premarket Approval), it may be subject to such 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.

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); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

3

This letter will allow you to begin marketing your device as described in your Section 510(k) I his letter will anow you to begin manxeting of substantial equivalence of your device to a legally premarket nothleation. "The I Dri munity of bactuation for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please If you desire specific advice for your cerros on our of the following numbers, based on the regulation number at the top of this letter:

21 CFR 876.xxxx(Gastroenterology/Renal/Urology)240-276-0115
21 CFR 884.xxxx(Obstetrics/Gynecology)240-276-0115
21 CFR 892.xxxx(Radiology)240-276-0120
Other240-276-0100

Also, please note the regulation entitled, "Misbranding by reference to premarket notification the Also, please note the regulation emilited, formation on your responsibilities under the Act from the 807.97). You may obtain other general information on your Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

Nancy C. Hodgdon

Nancy C. Brogdon Director, Division of Reproductive, Abdominal, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Page l of l

KUS 0458 510(k) Number (if known):

Aquilion LB CT Scanner TSX-201A Device Name:

Indications for Use:

X-ray imaging of whole body - Computerized Tomography Including: Axial Volumetric (Helical) CT Fluoroscopy

David G. Leppmann

(Division Sign-Off) (Division Sign-Coluctive, Abdominal, and Radiological Devices 510(k) Number

(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

OR

Over-The-Counter Use _________________________________________________________________________________________________________________________________________________________

(Optional Format 1-2-96)