(203 days)
The Sentinel system is intended for use in radiation therapy clinics to accurately position patients in a reproducible way, prior to treatment and to monitor the patient continuously during treatment. The system provides information about a patient's position and the adjustments required in order to position the patient as close as possible to a reference setup. During monitoring, the system reports deviations in the patient's position during treatment.
The Sentinel system is a new version of the Positioner system (previously registered with 510(k) Number K063839), updated with an application module for patient monitoring, cMotion (the design control documents are included in Appendices A and B).
Sentinel is an advanced system for surface contour localization and patient monitoring during the radiotherapy treatment process. The Sentinel platform is based on advanced laser technology with multipurpose software modules covering different tasks in the treatment procedure. The c4D multi-application software supports all modes of operation in one integrated package. The software is user friendly and requires a minimum of user interaction in the daily clinical workflow, while providing the advanced user with sophisticated data management, analysis and reporting functionalities. The software is designed to integrate with existing systems at the clinic, such as CT, linacs and R&V systems, and with motorized couch tops.
Sentinel includes two application modules, cPosition for fast and accuracy patient positioning and cMotion for motion detection during the treatment delivery procedure.
The Sentinel hardware consists of a single scanner unit containing the laser and camera, mounted in the ceiling in front of the gantry. The scanner is connected to the PC running the c4D software.
During patient surface acquisition, a laser line is swept along the patient while the camera records a number of images. From the data acquired, a complete 3D surface of the patient can be reconstructed using laser line triangulation. For patient positioning, the acquired surface is captured in a few seconds and can contain several hundred contours. For motion detection the number of contours is typically lowered so that the desired frame rate is achieved.
cPosition
Once the treatment planning has been performed, the resulting plan can be transferred to the Sentinel system through import from the industry-standard DICOM format, creating the reference data necessary for patient positioning. Reference data can also be by created using the Sentinel laser scanner. In the treatment room, synchronization with the LINAC or R & V (Record and Verify) system ensures that the correct reference data is called up automatically when the patient is selected for treatment, and also eliminates the need for any manual selection of the patient in the Sentinel system.
By advanced surface registration algorithms the actual patient position is compared to the predefined reference, suggesting within seconds a correction in six degrees of freedom of the patient's position. With interface to major accelerator vendors the suggested patient position is transferred to the respective couch control system and fast and accurate alignment is achieved.
cMotion
cMotion monitors the movement of the patient during treatment delivery and automatically warns if the patient moves outside the allowed tolerances.
The provided text describes the C-RAD Sentinel system, a radiotherapy positioning system. However, it does not contain the detailed information necessary to fully answer all aspects of your request regarding acceptance criteria and the study that proves the device meets them. This document is a 510(k) summary, which focuses on demonstrating substantial equivalence to a predicate device rather than providing a comprehensive study report with specific performance metrics and methodologies.
Here's a breakdown of what can be extracted and what is missing:
1. A table of acceptance criteria and the reported device performance:
The document broadly states the intended use, which implies certain performance goals, but it does not specify quantitative acceptance criteria or detailed reported performance figures in a table format.
| Acceptance Criteria (Implied) | Reported Device Performance (Implied/Stated) |
|---|---|
| Accurate patient positioning | Achieves "fast and accurate alignment" |
| Reproducible patient setup | Positions patients "in a reproducible way" |
| Continuous patient monitoring | Monitors patient movement during treatment, warns if movement is outside allowed tolerances |
| Integration with clinic systems | Designed to integrate with CT, linacs, R&V systems, and motorized couch tops |
| Fast surface acquisition | "Acquired surface is captured in a few seconds" |
| Suggests corrections in 6 DoF | "Suggesting within seconds a correction in six degrees of freedom" |
What's missing for point 1: Specific numerical values for accuracy (e.g., within X mm or degrees), reproducibility (e.g., standard deviation of Y mm), latency of motion detection, or specific thresholds for "allowed tolerances."
2. Sample size used for the test set and the data provenance (e.g., country of origin of the data, retrospective or prospective):
This information is not available in the provided 510(k) summary. The document mentions "performance data has been submitted," but does not detail the nature of this data, its sample size, or its provenance.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g., radiologist with 10 years of experience):
This information is not available in the provided 510(k) summary. Given the device's function (positioning and motion detection), the "ground truth" would likely involve physical measurements or phantoms, rather than expert interpretation of images.
4. Adjudication method (e.g., 2+1, 3+1, none) for the test set:
This information is not available in the provided 510(k) summary.
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:
This is not applicable to the Sentinel device as described. The Sentinel system is a radiotherapy positioning system that uses laser technology for surface contour localization and patient monitoring. It is not an AI-assisted diagnostic imaging device that human "readers" would interpret or benefit from in the way an MRMC study evaluates. The system provides objective positional data and alerts, rather than complex interpretations requiring human "reading."
6. If a standalone (i.e. algorithm only without human-in-the loop performance) was done:
The device inherently operates with "human-in-the-loop" for the positioning and treatment process, but its core function of detecting patient position and movement is an algorithm-only task. The system "suggests within seconds a correction" and "automatically warns if the patient moves outside the allowed tolerances." This implies a standalone capability for sensing and alerting based on its algorithms. However, the study specific to this standalone performance is not described with details of methodology or metrics.
7. The type of ground truth used (expert consensus, pathology, outcomes data, etc):
The document does not explicitly state the type of ground truth used for performance testing. Given the nature of the device (positioning and motion detection), the ground truth would likely be established through:
- Physical measurements: Using calibrated phantom devices, external measurement systems (e.g., optical tracking systems, micrometers, or other highly accurate instruments) to verify the accuracy of the Sentinel's reported positions and movements.
- Known displacements: Inducing precise, known movements in phantoms or test setups and verifying if the Sentinel system accurately detects and quantifies these movements.
8. The sample size for the training set:
This information is not available in the provided 510(k) summary. The Sentinel system uses "advanced surface registration algorithms." While such algorithms often involve training data (e.g., to learn surface features or model variations), the document does not specify any training set size. It's possible that the algorithms are based on fundamental physics and geometry rather than large-scale machine learning, in which case a "training set" might not be applicable in the same way as for AI image analysis.
9. How the ground truth for the training set was established:
This information is not available in the provided 510(k) summary for the reasons mentioned in point 8.
In summary: The provided 510(k) document serves its purpose of demonstrating substantial equivalence by outlining the device's function, intended use, and stating that performance data was submitted. However, it specifically lacks the detailed study methodology, quantitative acceptance criteria, specific performance metrics, sample sizes, and ground truth establishment methods that would be present in a comprehensive study report or a more detailed technical file.
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MAR 3 0 2009
C-RAD K082582
510(k) SUMMARY
Owner
C-RAD Positioning AB Bredgränd 14 753 20 Uppsala Phone no: +46 18 666930 Fax no:
Contact person
Cristina Svensson Chief Executive Officer Phone no: +46 18 666936
Date of preparation
September 1, 2008
Trade name of device Sentinel
Common name
Radiotherapy positioning system
Classification name
Medical charged-particle radiation therapy system Regulation: 21 CFR 892.5050
Predicate marketed devices
AlignRT (K052682) - Vision RT Ltd.
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Device description
The Sentinel system is a new version of the Positioner system (previously registered with 510(k) Number K063839), updated with an application module for patient monitoring, cMotion (the design control documents are included in Appendices A and B).
Sentinel is an advanced system for surface contour localization and patient monitoring during the radiotherapy treatment process. The Sentinel platform is based on advanced laser technology with multipurpose software modules covering different tasks in the treatment procedure. The c4D multi-application software supports all modes of operation in one integrated package. The software is user friendly and requires a minimum of user interaction in the daily clinical workflow, while providing the advanced user with sophisticated data management, analysis and reporting functionalities. The software is designed to integrate with existing systems at the clinic, such as CT, linacs and R&V systems, and with motorized couch tops.
Sentinel includes two application modules, cPosition for fast and accuracy patient positioning and cMotion for motion detection during the treatment delivery procedure.
The Sentinel hardware consists of a single scanner unit containing the laser and camera, mounted in the ceiling in front of the gantry. The scanner is connected to the PC running the c4D software.
During patient surface acquisition, a laser line is swept along the patient while the camera records a number of images. From the data acquired, a complete 3D surface of the patient can be reconstructed using laser line triangulation. For patient positioning, the acquired surface is captured in a few seconds and can contain several hundred contours. For motion detection the number of contours is typically lowered so that the desired frame rate is achieved.
cPosition
Once the treatment planning has been performed, the resulting plan can be transferred to the Sentinel system through import from the industry-standard DICOM format, creating the reference data necessary for patient positioning. Reference data can also be by created using the Sentinel laser scanner. In the treatment room, synchronization with the LINAC or R & V (Record and Verify) system ensures that the correct reference data is called up automatically when the patient is selected for treatment, and also eliminates the need for any manual selection of the patient in the Sentinel system.
By advanced surface registration algorithms the actual patient position is compared to the predefined reference, suggesting within seconds a correction in six degrees of freedom of the patient's position. With interface to major accelerator vendors the suggested patient position is transferred to the respective couch control system and fast and accurate alignment is achieved.
cMotion
cMotion monitors the movement of the patient during treatment delivery and automatically warns if the patient moves outside the allowed tolerances.
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Intended use
The Sentinel system is intended for use in radiation therapy clinics to accurately position patients in a reproducible way, prior to treatment and to monitor the patient continuously during treatment. The system provides information about a patient's position and the adjustments required in order to position the patient as close as possible to a reference setup. During monitoring, the system reports deviations in the patient's position during treatment.
Technological comparison
The Sentinel system is substantial equivalent to the predicate devices in terms of their intended use and technological characteristics. There are differences between the Sentinel system and predicate devices in terms of their principles of operation, materials, performance, human factors and energy delivered by the system. However, performance data has been submitted to show that Sentinel achieves its intended use and that these technological differences raise no new efficacy or safety concerns.
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Image /page/3/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES (USA)" around the perimeter. Inside the circle is a stylized image of an eagle with three lines representing its wings.
DEPARTMENT OF HEALTH & HUMAN SERVICES
Public Health Service
MAR $ 0 2003
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
Ms. Cristina Svensson CEO C-RAD Positioning AB Bredgränd 14 Uppsala 75320 SWEDEN
Re: K082582
Trade/Device Name: Sentinal Regulation Number: 21 CFR 892.5050 Regulation Name: Medical charged-particle radiation therapy system Regulatory Class: II Product Code: IYE Dated: February 23, 2009 Received: February 26, 2009
Dear Ms. Svensson:
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 (PMA), 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.
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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.
This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding os 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.xxx | (Gastroenterology/Renal/Urology) | (240) 276-0115 |
|---|---|---|
| 21 CFR 884.xxx | (Obstetrics/Gynecology) | (240) 276-0115 |
| 21 CFR 892.xxx | (Radiology) | (240) 276-0120 |
| Other | (240) 276-0100 |
Also, please note the regulation entitled, "Misbranding by reference to premarket notification'' (21 CFR Part 807.97). For questions regarding postmarket surveillance, please contact CDRH's Office of Surveillance and Biometrics' (OSB's) Division of Postmarket Surveillance at 240-276-3474. For questions regarding the reporting of device adverse events (Medical Device Reporting (MDR)), please contact the Division of Surveillance Systems at 240-276-3464. You may obtain other general information on your responsibilities under the Act from the Division of Small Manufactures. International and Consumer Assistance at its toll-free number (800) 638-2041 or (240) 276-3150 or at its Internet address http://www.fda.gov/cdrb/industry.suppot/index.html.
Sincerely yours,
Lorina M. Morris
anine M. Morris Acting Director, Division of Reproductive, Abdominal, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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INDICATIONS FOR USE
510(k) Number:
Device Name: Sentinel
Indications for use:
The Sentinel system is intended for use in radiation therapy clinics to accurately position patients in a reproducible way, prior to treatment and to monitor the patient continuously during treatment. The system provides information about a patient's position and the adjustments required in order to position the patient as close as possible to a reference setup. During monitoring, the system reports deviations in the patient's position during treatment.
The system shall only be used by hospital personnel, qualified to work in radiation therapy or diagnostics departments.
Helbert Reuner
(Division Sign-Off) Division of Reproductive, Abdominal and Radiological Devices 510(k) Number
Prescription Use
§ 892.5050 Medical charged-particle radiation therapy system.
(a)
Identification. A medical charged-particle radiation therapy system is a device that produces by acceleration high energy charged particles (e.g., electrons and protons) intended for use in radiation therapy. This generic type of device may include signal analysis and display equipment, patient and equipment supports, treatment planning computer programs, component parts, and accessories.(b)
Classification. Class II. When intended for use as a quality control system, the film dosimetry system (film scanning system) included as an accessory to the device described in paragraph (a) of this section, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 892.9.