K Number
K113754
Device Name
CFR QUANT
Date Cleared
2012-07-19

(211 days)

Product Code
Regulation Number
892.1200
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The cfrQuant coronary flow reserve (CFR) quantification software quantifies blood flow in the myocardial wall of the heart's left ventricle based on positron emission tomography (PET) images of radionuclide tracer distribution. The product is intended for use by trained professionals, such as nuclear technicians and nuclear medicine or nuclear cardiology physicians. The clinician remains ultimately responsible for the final assessment and diagnosis based on standard practices and visual interpretation of all PET data. The software accepts cardiac PET images of either N-13 ammonia or Rb-82 tracer uptake during two physiologic states: baseline (rest) and increased blood flow (stress). A mathematical model computes absolute myocardial perfusion (flow per mass of tissue, or cc/min/gm) at rest and stress. The ratio of stress-to-rest flow is termed the coronary flow reserve (CFR). Visual displays of absolute flow and CFR as well as their numeric quantification are presented to aid diagnostic interpretation of myocardial PET images.
Device Description
The coronary flow reserve (CFR) quantification (cfrQuant) system is a software package intended for use by nuclear medicine and nuclear cardiology physicians and technologists to perform clinical quantitative analysis on cardiac positron emission tomography (PET) image data. Archiving of output data will be supported for clinical diagnostics, quality control, and research. cfrQuant calculates absolute myocardial blood flow in cc/min/g using a twodimensional topographical map of PET tracer uptake and an integrated arterial input value. Absolute myocardial flow is calculated from a mathematical flow model validated using microspheres in animals (see Yoshida, Mullani and Gould in J Nuc Med 37:1701, 1996). To compute CFR, three inputs are required: integrated arterial activity in the early part after bolus injection, average myocardial activity in the late part after bolus injection, and correction factors for partial volume effects of the PET scanner. The first number comes from a region of interest (ROI) drawn in the thoracic aorta or left atrium on images taken soon after radionuclide bolus administration. The second number comes from the topographic maps of myocardial uptake produced by the Positron CARDIAC software. The third number varies by PET camera and will be initialized in a user preference file.
More Information

Not Found

No
The description focuses on a mathematical model and standard image processing techniques for quantification, with no mention of AI or ML.

No
The device is a software for quantifying blood flow from PET images to aid in diagnosis, not to treat or cure a disease.

Yes

The device "quantifies blood flow" and presents "visual displays of absolute flow and CFR as well as their numeric quantification" to "aid diagnostic interpretation of myocardial PET images." The output "will be supported for clinical diagnostics," indicating its role in assessing a patient's condition.

Yes

The device description explicitly states it is a "software package" and its function is to perform "clinical quantitative analysis on cardiac positron emission tomography (PET) image data." There is no mention of accompanying hardware components.

Based on the provided information, this device is not an In Vitro Diagnostic (IVD).

Here's why:

  • IVDs analyze biological samples (like blood, urine, tissue) outside the body. This device analyzes PET images, which are generated from the distribution of a radionuclide tracer within the patient's body.
  • The intended use is to quantify blood flow based on in vivo imaging data. The software processes images of tracer distribution within the heart, not a sample taken from the patient.
  • The inputs are PET images and derived values from those images. While it uses information about tracer uptake, this is based on the in vivo distribution, not an in vitro analysis of a biological sample.

Therefore, the cfrQuant software falls under the category of medical image analysis software or quantitative imaging software, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

cfrQuant is intended for quantification of absolute myocardial blood flow and coronary flow reserve when applied to diagnostic cardiac PET imaging in patients with suspected or known coronary artery disease.

The cfrQuant coronary flow reserve (CFR) quantification software quantifies blood flow in the myocardial wall of the heart's left ventricle based on positron emission tomography (PET) images of radionuclide tracer distribution.

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

KPS

Device Description

The coronary flow reserve (CFR) quantification (cfrQuant) system is a software package intended for use by nuclear medicine and nuclear cardiology physicians and technologists to perform clinical quantitative analysis on cardiac positron emission tomography (PET) image data. Archiving of output data will be supported for clinical diagnostics, quality control, and research.

cfrQuant calculates absolute myocardial blood flow in cc/min/g using a twodimensional topographical map of PET tracer uptake and an integrated arterial input value. Absolute myocardial flow is calculated from a mathematical flow model validated using microspheres in animals (see Yoshida, Mullani and Gould in J Nuc Med 37:1701, 1996).

To compute CFR, three inputs are required: integrated arterial activity in the early part after bolus injection, average myocardial activity in the late part after bolus injection, and correction factors for partial volume effects of the PET scanner. The first number comes from a region of interest (ROI) drawn in the thoracic aorta or left atrium on images taken soon after radionuclide bolus administration. The second number comes from the topographic maps of myocardial uptake produced by the Positron CARDIAC software. The third number varies by PET camera and will be initialized in a user preference file.

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

cardiac PET image

Anatomical Site

myocardial wall of the heart's left ventricle

Indicated Patient Age Range

Not Found

Intended User / Care Setting

nuclear medicine and nuclear cardiology physicians and technologists.
trained professionals, such as nuclear technicians and nuclear medicine or nuclear cardiology physicians.

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.

K101279, K083327, K080770

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

§ 892.1200 Emission computed tomography system.

(a)
Identification. An emission computed tomography system is a device intended to detect the location and distribution of gamma ray- and positron-emitting radionuclides in the body and produce cross-sectional images through computer reconstruction of the data. This generic type of device may include signal analysis and display equipment, patient and equipment supports, radionuclide anatomical markers, component parts, and accessories.(b)
Classification. Class II.

0

5. 510(k) Summary

K 113754

JUL 19 2012

Owner/Contact:

K. Lance Gould. M.D. Professor of Cardiovascular Medicine University of Texas Medical School at Houston 6431 Fannin St., Suite MSB 4.256 Houston, TX 77030 Phone 713 500 6611 Fax 713 500 6615 Email K.Lance.Gould@uth.tmc.edu

Date of preparation: December 19, 2011

Device trade name: cfrQuant

Common name: Coronary Flow Reserve (CFR) Quantification

Classification names: emission computed tomography system (21 CFR 892.1200, Product Code KPS)

Devices claimed for equivalence:

General description: The coronary flow reserve (CFR) quantification (cfrQuant) system is a software package intended for use by nuclear medicine and nuclear cardiology physicians and technologists to perform clinical quantitative analysis on cardiac positron emission tomography (PET) image data. Archiving of output data will be supported for clinical diagnostics, quality control, and research.

cfrQuant calculates absolute myocardial blood flow in cc/min/g using a twodimensional topographical map of PET tracer uptake and an integrated arterial input value. Absolute myocardial flow is calculated from a mathematical flow model validated using microspheres in animals (see Yoshida, Mullani and Gould in J Nuc Med 37:1701, 1996).

To compute CFR, three inputs are required: integrated arterial activity in the early part after bolus injection, average myocardial activity in the late part after bolus injection, and correction factors for partial volume effects of the PET scanner. The first number comes from a region of interest (ROI) drawn in the thoracic aorta or left atrium on images taken soon after radionuclide bolus administration. The second number comes from the topographic maps of myocardial uptake produced by the Positron CARDIAC software. The third number varies by PET camera and will be initialized in a user preference file.

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1

Intended use: cfrQuant is intended for quantification of absolute myocardial blood flow and coronary flow reserve when applied to diagnostic cardiac PET imaging in patients with suspected or known coronary artery disease.

Technological characteristics: CFR is a software package that uses standard, industrial computing hardware and applications.

2

Image /page/2/Picture/0 description: The image shows the logo for the Department of Health & Human Services USA. 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 its wings spread.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room - WO66-G609 Silver Spring. MD 20993-0002

K. Lance Gould, M.D. Professor of Cardiovascular Medicine University of Texas Medical School at Houston 6431 Fannin Street. Suite MSB 4.256 HOUSTON TX 77030

JUL 19 2012

Re: K113754

Trade/Device Name: cfrQuant (Coronary Flow Reserve Quantification) Regulation Number: 21 CFR 892.1200 Regulation Name: Emission computed tomography system Regulatory Class: II Product Code: KPS Dated: July 3, 2012 Received: July 6, 2012

Dear Dr. Gould:

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 class II (Special Controls), it may be subject to such additional controls. Existing major regulations affecting your device can be found in Title 21, Code of Federal Regulations (CFR), Parts 800 to 895. 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 Parti807); labeling (21 CFR:Parts 801 and 809); medical device reporting (reporting of

3

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medical device-related adverse events) (21 CFR 803); and good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820). 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 Parts 801 and 809), please contact the Office of In Vitro Diagnostic Device Evaluation and Safety at (301) 796-5450. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

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) 796-7100 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely Yours,

Janine M. Morris

Acting Director Division of Radiological Devices Office of In Vitro Diagnostic Device Evaluation and Safety Center for Devices and Radiological Health

Enclosure

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Comments of Children Comments


4. Indications for Use

510(k) Number: K113754

Device Name: cfrQuant (Coronary Flow Reserve Quantification)

:

Indications for Use:

The cfrQuant coronary flow reserve (CFR) quantification software quantifies blood flow in the myocardial wall of the heart's left ventricle based on positron emission tomography (PET) images of radionuclide tracer distribution.

The product is intended for use by trained professionals, such as nuclear technicians and nuclear medicine or nuclear cardiology physicians. The clinician remains ultimately responsible for the final assessment and diagnosis based on standard practices and visual interpretation of all PET data.

The software accepts cardiac PET images of either N-13 ammonia or Rb-82 tracer uptake during two physiologic states: baseline (rest) and increased blood flow (stress). A mathematical model computes absolute myocardial perfusion (flow per mass of tissue, or cc/min/gm) at rest and stress. The ratio of stress-torest flow is termed the coronary flow reserve (CFR). Visual displays of absolute flow and CFR as well as their numeric quantification are presented to aid diagnostic interpretation of myocardial PET images.

Prescription Use YES (Part 21 CFR 801 Subpart D)

Over-The-Counter Use NO (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)

Arush D. Shah

(Division Sign-Off)
Division of Radiological Devices
Office of In Vitro Diagnostic Device Evaluation and Safety
510K
K113754