(29 days)
The Imaging Sciences International Inc. DVT Scanner constructs a three dimensional model from images taken during a rotational X-ray sequence. The DVT Scanner is intended to be used whenever a dentist, oral surgeon, or other physician needs 3D information of high contrast objects. The DVT Scanner is optimized for imaging of TM Joint studies, mandible & maxilla for implant planning, sinuses, the maxillofacial complex, temporal bone, etc.
The DVT Scanner is a dedicated X-Ray imaging device that acquires a 360 degree rotational X-ray sequence, reconstructs a three-dimensional that aod a boo adgrounde and produces two dimensional views of this volume. The matix of the oxamined stances and thickness on two dimensional images. Images produced by the DVT Scanner can be printed or exported on magnetic and optical media.
The DVT Scanner gantry is comprised of an X-ray source, image detector, and motorized gantry. The gantry facilitates the acquisition of a full X-ray sequence by the software. The software receives the two dimensional images acquired by the detector, sonward. The bormal images and displays them on the workstation monitor for viewing.
This 510(k) submission (K051980) for the DVT Scanner by Imaging Sciences International Inc. primarily focuses on substantial equivalence to predicate devices and does not include a comparative study or detailed acceptance criteria with performance metrics in the provided document. The submission is a premarket notification to establish that the DVT Scanner is at least as safe and effective as a legally marketed device.
Therefore, many of the requested sections below cannot be populated as the information is not present in the provided text.
Acceptance Criteria and Study Details for DVT Scanner (K051980)
1. Table of Acceptance Criteria and Reported Device Performance
The provided document does not explicitly state specific acceptance criteria or quantitative performance metrics for the DVT Scanner. The approval is based on substantial equivalence to predicate devices, implying that its performance is considered comparable to those devices.
| Acceptance Criterion | Reported Device Performance |
|---|---|
| Not CITED | Not CITED |
The document states, "The DVT Scanner complies with the requirements of 21 CFR 807.87 and does not pose any new safety risks or effectiveness issues." This is a high-level statement and not a specific performance metric.
2. Sample Size Used for the Test Set and Data Provenance
The provided document does not mention any specific test set, its sample size, or data provenance (e.g., country of origin, retrospective or prospective) for a standalone device performance study. The approval is based on substantial equivalence.
3. Number of Experts Used to Establish Ground Truth and Qualifications
The provided document does not describe any study involving experts to establish ground truth. The submission is focused on substantial equivalence to existing devices.
4. Adjudication Method for the Test Set
Since no specific test set or study for ground truth establishment is described, there is no mention of an adjudication method in the provided document.
5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study
The provided document does not indicate that a Multi-Reader Multi-Case (MRMC) comparative effectiveness study was performed. The submission focuses on device equivalence, not on comparing human reader performance with and without AI assistance.
6. Standalone (Algorithm Only Without Human-in-the-Loop) Performance Study
The provided document does not describe a standalone performance study for the DVT Scanner's algorithm. The device is described as an X-ray imaging system that reconstructs 3D models and displays them for interpretation by a dentist, oral surgeon, or other physician, inherently implying human-in-the-loop use.
7. Type of Ground Truth Used
The provided document does not mention the type of ground truth used as no specific performance study against a ground truth is detailed.
8. Sample Size for the Training Set
The provided document does not specify any training set size as it does not describe the development or validation of a machine learning or AI algorithm in the context of a training set. The device is an imaging system, not an AI-driven diagnostic tool in the sense of modern AI/ML submissions.
9. How the Ground Truth for the Training Set Was Established
As no training set is mentioned (see point 8), there is no information on how ground truth for a training set was established in the provided document.
Summary of Information from the Provided Text:
The K051980 submission for the DVT Scanner is a premarket notification for a Computed Tomography X-ray System. It asserts substantial equivalence to three predicate devices: NewTom QR - DVT 900 (K003787), Advantage 3-D XR (K945375), and 3D Accu-l-tomo XYZ Slice View Tomograph (K030450). The DVT Scanner is described as a device that acquires a 360-degree rotational X-ray sequence to reconstruct a three-dimensional model, producing two-dimensional views for dentists, oral surgeons, or other physicians to obtain 3D information of high-contrast objects. Its intended uses include TM Joint studies, mandible & maxilla for implant planning, sinuses, the maxillofacial complex, and temporal bone studies. The document concludes that the device complies with regulations and does not pose new safety risks or effectiveness issues, based on its design, development, verification, and validation process, which includes a risk management system. However, specific performance metrics, study designs, sample sizes, or ground truth methodologies are not detailed in this 510(k) summary.
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K05/980
AUG 1 9 2005
510 (k) Summary
Submitters Information
Name:
Address:
Phone Number:
Fax Number:
Person To Contact:
-Date Of Summary:
Trade Name Of The Device:
Common Or Usual Name:
Classification Name:
Imaging Sciences International Inc.
1910 North Penn Road Hatfield PA, 19440
215-997-5666
215-997-5665
David W. Cowan Vice President of Engineering, Quality Assurance and Government Compliance
July 20, 2005
DVT Scanner
Computed Tomography X-ray System
Computed Tomography X-ray System
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Substantial Equivalence Claim: The Imaging Sciences International Inc. DVT Scanner is substantially equivalent to the devices listed below:
| Device: | NewTom QR - DVT 900 |
|---|---|
| Manufacturer: | NIM s.r.1.Via Silverstrini, 2037135 VeronaItaly |
| 510 (k) Number: | K003787 |
| Device: | Advantage 3-D XR |
| Manufacturer: | General Electric Medical Systems283, rue de la Miniere78533 Buc CedexFrance |
| 510 (k) Number: | K945375 |
| Device: | 3D Accu-l-tomo XYZ Slice View Tomograph |
| Manufacturer: | J. Morita Manufacturing Corporation680 Higashihama Minami-cho, Fushimi-kuJapan |
| 510 (k) Number: | K030450 |
Description Of The Device: The DVT Scanner is a dedicated X-Ray imaging device that acquires a 360 degree rotational X-ray sequence, reconstructs a three-dimensional that aod a boo adgrounde and produces two dimensional views of this volume. The matix of the oxamined stances and thickness on two dimensional images. Images produced by the DVT Scanner can be printed or exported on magnetic and optical media.
The DVT Scanner gantry is comprised of an X-ray source, image detector, and motorized gantry. The gantry facilitates the acquisition of a full X-ray sequence by the software. The software receives the two dimensional images acquired by the detector, sonward. The bormal images and displays them on the workstation monitor for viewing.
Intended Use Of The Device: The DVT Scanner is an X-ray imaging device that constructs a three dimensional model from images taken during a rotational X-ray sequence. The DVT Scanner is intended to be used whenever a dentist, oral surgeon, or other physician needs 3D information of high contrast objects. The DVT Scanner is or other primaging of TM Joint studies, mandible & maxilla for implant planning, sinuses, the maxillofacial complex, temporal bone, etc.
Comparison with Predicate Devices: The DVT Scanner reconstructs a three dimensional model from X-ray images similar to the model obtained using the predicate
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devices. It displays either two-dimensional cross-sections or three dimensional views and allows the user to take measurements on reconstructed images.
Conclusions: The DVT Scanner Acquires an X-ray rotational sequence and provides and three-dimensional information on the analyzed volume. The potential hazards (e.g. tiffee-umlensional information on the interest measurements or misdiagnosis) are elcontrolled by the design development, verification and validation process which includes a risk management system.
The DVT Scanner complies with the requirements of 21 CFR 807.87 and does not pose any new safety risks or effectiveness issues.
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Image /page/3/Picture/1 description: The image shows a circular logo with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the top half of the circle. In the center of the circle is a stylized image of an eagle with three curved lines representing its wings and body. The logo is black and white.
Public Health Service
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
AUG 1 9 2005
Mr. Dave Cowan Vice President of Engineering, Quality Assurance and Government Compliance Imaging Sciences International, Inc. 1910 North Penn Road HATFIELD PA 19440
Re: K051980 Trade/Device Name: DVT Scanner Regulation Number: 21 CFR 892.1750 Regulation Name: Computed tomography x-ray system
Regulatory Class: II Product Code: JAK Dated: July 20, 2005 Received: July 27, 2005
Dear Mr. Cowan:
Dour Nr. Overally we have reviewed your becally broths) preisantially equivalent (for the indications for use stated in above and have decemined the as reedicate devices marketed in interstate commerce prior to the cherosate) to tegary mancess presional Device Amendments, or to devices that have been May 20, 1770, the chaomient acts 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 do not require approval of a promance approvisions of the Act. The general controls provisions of the Act device, subject to the general economic 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 If your device is classified (500 acon additional controls. Existing major regulations affecting your Apployal), it they oc sabject to between 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 I teast of advisou that i 27 rion that your device complies with other requirements of the Act or any I DA nas made a acteriminations administered by other Federal agencies. You must comply with all the r caral surves and regulating, but not limited to registration and listing (21 CFR Part 807); labeling Act 3 requirements, invidenty, between gractice requirements as set forth in the quality systems (QS) (21 CFR Part 801); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.
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This letter will allow you to begin marketing your device as described in your Section 510(k)
The States of the Research Figure freebotential equivalence of your device to a This letter will allow you to begin maketing your as assence of your device of your device to a legally
premarket notification. The FDA inn has if seus device and this perm premarket notification. The FDA Inding of Substantial or your device and thus, permits your device to proceed to the market.
lf you desire specific advice for your device on our labeling regulation (21 Clik Parl 801), please
s and the success on and commend the following numbers, based on the reg If you desire specific advice for your device on our labering regulation (
contact the Office of Compliance at one-of the following numbers, based and the regulation number a the top of this letter:
| (Gastroenterology/Renal/Urology) | 240-276-0115 | |
|---|---|---|
| 21 CFR 876.xxxx | (Obstetrics/Gynecology) | 240-276-0115 |
| 21 CFR 884.xxxx | 240-276-0120 | |
| 21 CFR 892.xxxx | (Radiology) | 240-276-0100 |
| Other |
Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Also, please note the regulation entitled, "Misoration on your responsibilities under the Act from the 807.97). You may obtain other geherar information on your respendential.
Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) DIVISION of Small Manass97 or at its Internet address 038-2041 of (2017) 145-0577 175-05-2017 01:11:11 PM ...
http://www.fda.gov/cdrh/industry/support/index.html.
Sincerely yours,
Nancy C. Brogdon
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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Kos 1980
Indications for Use
510(k) Number (if known):_____________________________________________________________________________________________________________________________________________________
2x - 4
Device Name: _________________________________________________________________________________________________________________________________________________________________
Indications For Use: The Imaging Sciences International Inc. DVT Scanner constructs multations For Goe. The images taken during a rotational X-ray sequence. The a thickslonal model from the med whenever a dentist, oral surgeon, or other DVT Scanner is mendou to be assur high contrast objects. The DVT Scanner is optimized physician necus 3D information of mgilla for implant planning, sinuses, the maxillofacial complex, temporal bone, etc.
Prescription Use × (Part 21 CFR 801 Subpart D) AND/OR
Over-The-Counter Use (21 CFR 801 Subpart C)
(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)
Concurrence of CDRH, Office of Device Evaluation (ODE)
Nancy Brogdon
(Division Sign-Off) Division of Reproductive, Abdomin and Radiological Devices 510(k) Number
Page 1 of 1 __
§ 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.