K Number
K052587
Device Name
3D ACCU-I-TOMO XYZ SLICE VIEW TOMOGRAPH, MODEL MCT-1 EXF
Date Cleared
2005-12-27

(98 days)

Product Code
Regulation Number
892.1750
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Model MCT-1 EXF is an x-ray imaging device that acquires a 360 degree rotational sequence of the head and neck areas, including the ENT and dentomaxillofacial areas, for use in diagnostic support. The device accomplishes this task by reconstructing a three-dimensional matrix of the examined volume and producing two-dimensional views of this volume, displaying both two- and threedimensional images. The device is operated and used by physicians, dentists, and x-ray technologists.
Device Description
The MCT-1 EX F is an X-ray CT using the limited cone beam. MCT-1 EX F makes diagnosis be possible due to its high resolution three dimensional images for small diagnosis be possible add to the extremely complex morphology of the hard tissue of the head and neck region. High resolution images are obtained in the same short period as that of the Panoramic Radiology. Low X-ray radiation dosage is realized and the overall system structure is assembled to be compact unit. The J.MORITA. MFG. CORP. has manufactured the MCT-1EX as the original model of such kind of X-ray scanner, and modify the device for MCT-1 EX F by replacing the image receptor , XII for FPD ( Flat Panel Detector).
More Information

Not Found

No
The document describes a standard cone beam CT device and its modifications, focusing on hardware changes (image receptor). There is no mention of AI, ML, or advanced image processing techniques that would suggest the use of these technologies.

No.
The device is described as an x-ray imaging device for diagnostic support, reconstructing a three-dimensional matrix for diagnostic purposes, not for treating any condition.

Yes

The "Intended Use / Indications for Use" section explicitly states that the device acquires images "for use in diagnostic support." Additionally, the "Device Description" mentions that the device "makes diagnosis be possible."

No

The device description explicitly states it is an "X-ray CT" and describes hardware components like an "image receptor" and "Flat Panel Detector," indicating it is a physical medical device, not software-only.

Based on the provided information, the Model MCT-1 EXF is not an In Vitro Diagnostic (IVD).

Here's why:

  • IVDs analyze samples taken from the human body. This device is an imaging device that uses X-rays to create images of the head and neck within the body.
  • The intended use is for diagnostic support based on imaging. The device acquires and reconstructs images for physicians and dentists to use in diagnosis. It does not analyze biological samples like blood, urine, or tissue.

The device is clearly described as an X-ray imaging device, specifically a Cone Beam CT scanner, used for visualizing anatomical structures. This falls under the category of medical imaging devices, not IVDs.

N/A

Intended Use / Indications for Use

The MCT-1 EX F is intended to be used for three dimensional X-ray Computed The ITCT + DF + 1 to med and neck by limited cone shaped x-ray beam projected on to an FPD to be operated and used by doctors, dentists, properly licensed professionals and other legally qualified professionals.

The Model MCT-1 EXF is an x-ray imaging device that acquires a 360 degree rotational sequence of the head and neck areas, including the ENT and dentomaxillofacial areas, for use in diagnostic support. The device accomplishes this task by reconstructing a three-dimensional matrix of the examined volume and producing two-dimensional views of this volume, displaying both two- and threedimensional images. The device is operated and used by physicians, dentists, and x-ray technologists.

Product codes (comma separated list FDA assigned to the subject device)

901AK, JAK

Device Description

The MCT-1 EX F is an X-ray CT using the limited cone beam. MCT-1 EX F makes diagnosis be possible due to its high resolution three dimensional images for small diagnosis be possible add to the extremely complex morphology of the hard tissue of the head and neck region

High resolution images are obtained in the same short period as that of the Panoramic Radiology. Low X-ray radiation dosage is realized and the overall system structure is assembled to be compact unit.

The J.MORITA. MFG. CORP. has manufactured the MCT-1EX as the original model of such kind of X-ray scanner, and modify the device for MCT-1 EX F by replacing the image receptor , XII for FPD ( Flat Panel Detector).

Mentions image processing

reconstructing a three-dimensional matrix of the examined volume and producing two-dimensional views of this volume, displaying both two- and threedimensional images.

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

X-ray Computed Tomography (limited cone beam)

Anatomical Site

head and neck areas, including the ENT and dentomaxillofacial areas

Indicated Patient Age Range

Not Found

Intended User / Care Setting

doctors, dentists, properly licensed professionals and other legally qualified professionals.
physicians, dentists, and x-ray technologists

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): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K030450

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

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

DEC 2 7 2005

510(k) SUMMARY

J. Morita USA. Inc.'s

3D Accu-I-tomo XYZ Slice View Tomograph MCT-1 EX F

1. Submitter Name and Address with Phone/Fax :

Registration No. 2081055 Initial Distributor: J. Morita USA, Inc. 9 Mason Irvine, CA 92618 USA 949-581-9600 Telephone: 949-581-9688 Facsimile:

2. Contact Person

Keith A. Barritt Fish & Richardson P.C. 1425 K Street, N.W. Suite 1100 Washington, DC 20005 Phone: (202) 783-5070 Facsimile: (202) 783-2331

  • August 31, 2005 3. Date summary prepared:
  • Device Name: 4. 3D Accu-I-tomo XYZ Slice View Tomograph Trade or Proprietary Name: MCT-1 EX F Model:

Cone beam x-ray CT Common Name: Computed tomography x-ray system Classification Name: ( 21CFR 892.1750 )

901AK Product Code :

    1. Substantial Equivalency is claimed against the following device: 3D Accu-1-tomo XYZ Slice View Tomograph MCT-1 EX From 510k # K030450 J. MORITA MFG.CORP

1

6. Description of the device:

The MCT-1 EX F is an X-ray CT using the limited cone beam. MCT-1 EX F makes diagnosis be possible due to its high resolution three dimensional images for small diagnosis be possible add to the extremely complex morphology of the hard tissue of the head and neck region

High resolution images are obtained in the same short period as that of the Panoramic Radiology. Low X-ray radiation dosage is realized and the overall system structure is assembled to be compact unit.

The J.MORITA. MFG. CORP. has manufactured the MCT-1EX as the original model of such kind of X-ray scanner, and modify the device for MCT-1 EX F by replacing the image receptor , XII for FPD ( Flat Panel Detector).

7. Intended Use

The MCT-1 EX F is intended to be used for three dimensional X-ray Computed The ITCT + DF + 1 to med and neck by limited cone shaped x-ray beam projected on to an FPD to be operated and used by doctors, dentists, properly licensed professionals and other legally qualified professionals.

Safety and effectiveness of the device 8.

As the MCT-1 EX F is modified from our legally marketed device, MCT- 1 EX (K#030450) by replacing image receptor from XII to FPD with remaining all the other parts be common, so that the MCT-1 EX F is substantially equivalent to MCT-1EX as is shown in the comparison summary table below because they have . . similar general intended uses, technological characteristics and operating principles.

Any differences in the technological characteristics do not raise any new issues of safety or effectiveness.

This new submissionPredicateDifference
Name of the modelMCT-1 EX FMCT-1EXDifferent
ManufacturerJ.MORITA MFG. CORP.J.MORITA MFG. CORP.Identical
ConstructionRotating arm and baseRotating arm and baseSame
Image ReceptorFlat Panel DetectorX-ray image intensifierDifferent
Chin RestEquippedEquipped NOTE-1Identical
Performance spec.Computed tomographyComputed tomographyIdentical
MechanicalMCT mechanismMCT mechanismSame
ElectricalMCT electric circuitMCT electric circuitSame
SoftwareMCT softwareMCT softwareIdentical
TestingVDE NOTE-2VDE NOTE-2Same

NOTE-I The original submission does not include Chin rest , but this is noluded in MCT-1EX through our in-house revision procedure named "510(K) memo " documentation as shown at Attachment 11 in this submission

NOTE-2 The notified body of VDE has tested and certified for CE marking with CB report on MCT-1 EX F which is to be accessed

2

MCT-1 EX F to MCT-1EX
FDA file reference number510k number of MCT-1EX
K030450
TECHNOLOGICAL
CHARACTERISTICSComparison result
Indication for useIdentical
Target populationIdentical
DesignSimilar
MaterialsSimilar
PerformanceIdentical
SterilitySimilar
BiocompatibilitySimilar
Mechanical safetySimilar
Chemical safetySimilar
Anatomical sitesIdentical
Human factorsIdentical
Energy used and/or deliveredIdentical
Compatibility with environment
and other devicesIdentical
Where usedIdentical
Standards metSimilar
Electrical safetySimilar
Thermal safetySimilar
Radiation safetySimilar

Substantial Equivalent comparison summary table

3

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is an abstract symbol resembling a stylized caduceus or a representation of human figures, with three horizontal lines above a wavy line.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

DEC 2 7 2005

J. Morita USA. Inc. c/o Mr. Keith A. Barritt Fish & Richardson P.C. 1425 K Street, N.W., Suite 1100 11" Floor WASHINGTON DC 200005

Re: K052587

Trade/Device Name: 3D Accu-I-tomo XYZ Slice View Tomograph Model MCT-1 EXF Regulation Number: 21 CFR §892.1750 Regulation Name: Computed tomography x-ray system Regulatory Class: II Product Code: JAK Dated: September 19, 2005 Received: October 11, 2005

Dear Mr. Barritt:

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 (OS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

4

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification 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 contact the Office of Compliance at one 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" (21 CFR 807.97). You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer 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

5

K052587

510(k) Number (if known):

3D Accu-I-tomo XYZ Slice View Tomograph Model MCT-1 EXF Device Name:

Indications For Use:

The Model MCT-1 EXF is an x-ray imaging device that acquires a 360 degree rotational sequence of the head and neck areas, including the ENT and dentomaxillofacial areas, for use in diagnostic support. The device accomplishes this task by reconstructing a three-dimensional matrix of the examined volume and producing two-dimensional views of this volume, displaying both two- and threedimensional images. The device is operated and used by physicians, dentists, and x-ray technologists.

Prescription Use (Part 21 CFR 801 Subpart D)

ANDIOR

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)

Daniel R. Heymann

(Division Sign-Off) Division of Reproductive, Abdominal, and Radiological Devices 510(k) Number .

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