K Number
K120993
Date Cleared
2012-07-26

(115 days)

Product Code
Regulation Number
892.5700
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The GammaMedplus iX™ Series is indicated for use in the treatment of both benign and malignant disease, for both curative and palliative intent, in the delivery of High Dose Rate (HDR) and Pulsed Dose Rate (PDR) remote-controlled brachytherapy.

Device Description

The GammaMedplus iX Series afterloader systems are computer controlled remote electro/mechanical systems used for medical purposes, for placing a cable incorporating an irradiated iridium seed internally or close by a malignant tumor or tumor bed in a practice known as brachytherapy.

AI/ML Overview

The provided text is a 510(k) Summary for the GammaMedplus™ iX and GammaMedplus™ 3/24 iX afterloaders. This document focuses on demonstrating substantial equivalence to predicate devices through technological characteristic comparison and non-clinical testing. It does not contain information about acceptance criteria in terms of performance metrics like sensitivity, specificity, or accuracy, nor does it describe a study proving the device meets such criteria in a clinical sense.

Medical devices like brachytherapy afterloaders are evaluated for safety and effectiveness through different types of assessments than, for example, diagnostic AI algorithms. Their "performance" is typically related to precise mechanical operation, safety mechanisms, and adherence to dose delivery protocols.

Here's an analysis based on the information provided and what is intentionally absent from this type of regulatory submission:

1. A table of acceptance criteria and the reported device performance

The document does not explicitly state "acceptance criteria" in the format of sensitivity, specificity, or similar performance metrics typically seen for diagnostic AI. Instead, the "acceptance criteria" for this device are implicitly tied to demonstrating substantial equivalence to predicate devices and meeting safety and functional specifications. The "reported device performance" is a comparative analysis of its technological characteristics against the predicate devices (Nucletron MicroSelectron V3 and GammaMedplus iX Series HDR Afterloaders (K071381)).

Below is a table summarizing key characteristics that would be considered "performance" in the context of this device, comparing the proposed device (GammaMedplus™ iX, Console Software version 1.2) against its predicate (Nucletron MicroSelectron V3). The "acceptance criteria" are implied to be that the proposed device performs at least as well as or is equivalent to the predicate.

Feature / CharacteristicAcceptance Criteria (Implied: Comparator = Nucletron MicroSelectron V3)Reported Device Performance (GammaMedplus™ iX (Console SW v1.2))
PDR (Pulsed Dose Rate)Yes (Present in predicate)Yes for GammaMedplus iX (No for GammaMedplus 3/24 iX)
Max. exposure rate at 1m distance (containing max activity)<0.15 µSv/hr (with 10 Ci source)0.3 mrem/hr (3 µSv/hr) (with 15 Ci source - higher activity)
Dwell positions per each channel4860
Verification of channel lengthNo (Not present in predicate)Yes
Verification of applicator connectionNo (Not present in predicate)Yes (with noted exceptions for certain channels/applicators)
Max. source position error+/- 1mm per position0.35 % referring to 600 mm
Maximum activity (source)518 GBq / 14 Ci555 GBq / 15 Ci
Remote service accessNot available (Not present in predicate)Allows Varian service engineers to log in remotely
Partial Treatment OptionsPartial treatment options (including "redistribute undelivered portion")Removed "redistribute undelivered portion" partial treatment option
Fraction EditingSupport for fraction adding and modificationDisallowed if the fraction contains dose information

Note on "Max. exposure rate": The proposed device has a higher maximum activity (15 Ci vs 10 Ci in the predicate), which inherently allows for a higher exposure rate. The specified value of 0.3 mrem/hr (3 µSv/hr) for the higher activity would need to be considered acceptable from a safety perspective, likely meeting some regulatory threshold for leakage radiation. The document implicitly claims "performa as well or better than the predicate."

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

The document explicitly states: "No Clinical tests have been included in this pre-market submission."

Therefore, there is no "test set" in the context of patient data, no sample size, and no data provenance from clinical sources for performance evaluation. The "tests" mentioned are non-clinical, focusing on software and hardware functionality.

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)

Since no clinical tests or human-in-the-loop evaluations were performed or submitted, there was no need for experts to establish ground truth for a test set. Ground truth, in this context, would be based on engineering specifications, physical measurements, and regulatory standards for safety and performance of medical devices.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

Not applicable, as no clinical test set or expert ground truth was established for performance evaluation with patient data.

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

Not applicable. This device is an afterloader for brachytherapy, not a diagnostic AI tool that assists human readers in interpreting medical images. There are no human readers or AI assistance in that context for this device.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

This refers to the "Non Clinical Tests" section. The document states:
"For each device, in every mode of use, a full set of verification tests were performed on every pertinent aspect of the software and hardware to determine the safe functioning of the device."

This constitutes a standalone evaluation of the device's functional performance against engineering and safety specifications, without human intervention in the "performance" as one might see in an AI algorithm. The device's performance here relates to its mechanical accuracy, software control, shielding, dose delivery capabilities (though not clinical dose), and safety features.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

For the non-clinical tests, the "ground truth" would be the engineering specifications, design requirements, and established industry standards for brachytherapy devices. For example:

  • Mechanical Accuracy: Measured distances and positions verified against design specifications.
  • Radiation Leakage: Measured radiation levels compared against regulatory limits.
  • Software Functionality: Software outputs and control actions verified against expected behavior and safety interlocks.
  • Source Activity: Measurements verified against manufacturer specifications.

8. The sample size for the training set

Not applicable. This is not an AI/machine learning device that requires a training set of patient data.

9. How the ground truth for the training set was established

Not applicable, as there is no training set for this type of device.

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120993

JUL 26 2012

PREMARKET NOTIFICATION

510(k) Summary

GammaMedplus™ iX and GammaMedplus™ 3/24 iX

As required by 21 CFR 807.92

Submitter's Name:Varian Medical Systems3100 Hansen Way, m/s E110Palo Alto CA94304NucletronMicroSelectron V3GammaMedplus™ iX,(with ConsoleSoftware version 1.1)GammaMedplus™ iX,(with Console Softwareversion 1.2)
Contact Name: Ms Vy Tran,Vice President, Regulatory Affairs and Quality SystemsPhone: 650/424.5731Fax: 650/842.5040vy.tran@varian.comDate: 23rd March 2012Predicate DeviceClearance Number:K061354K071381N/A
Proprietry Name:GammaMedplus™ iX and GammaMedplus™ 3/24 iXIndications for UseThe MicroSelectron V3 isintended to enable anoperator to apply, by remotecontrol, a radionuclide sourceinto the body (includingInterstitial, Intracavitary,Intraluminal, Bronchial,Endovascular, and Intra-operative) or to the surfaceof the body for radiationtherapy.Both the GammaMedplus iXand GammaMedplus 3/24 iXare indicated, in thetreatment of both benignand malignant disease, forboth curative and palliativeintent, in the delivery ofremote controlled high doserate brachytherapy forconditions anywhere in thebody when brachytherapytreatment is indicated.The GammaMedplus™ iXSeries is indicated for use inthe treatment of both benignand malignant disease, forboth curative and palliativeintent, in the delivery ofremote-controlled High DoseRate (HDR) and Pulsed DoseRate (PDR) brachytherapy.
Classification Name:Remote controlled radionuclide applicator system21CFR892.5700Class IIIntended useThe MicroSelectron V3 isintended to enable anoperator to apply, by remotecontrol, a radionuclide sourceinto the body (includingInterstitial, Intracavitary,Intraluminal, Bronchial,Endovascular, and Intra-operative) or to the surfaceof the body for radiation.therapy.The GammaMedplus iXSeries is computer controlledremote HDR Afterloaderused to place a high activityradioactive source within aneedle(s) or applicator(s)which have previously beenplaced for a specified clinicalpurpose in a patient.The radioactive source(enclosed within thewire/cable) is driven viacoupling catheters (TransferGuide Tubes ) from theAfterloader into needles orapplicators within or on thepatient.The length of time andposition that the High DoseRate source spends withinthe needle or applicator iscontrolled in accordancewith an IrradiationTreatment Prescription.The GammaMedplus iX™Series is intended for use inthe treatment of both benignand malignant disease, forboth curative and palliativeintent, in the delivery ofremote-controlled High DoseRate (HDR) and Pulsed DoseRate (PDR) brachytherapy.
Common/Usual Name:GammaMedplus™ iX afterloader,GammaMedplus™ iX,GammaMedplus™ iX seriesGammaMedplus™ iX series afterloader systems,GammaMedplus™ iX series afterloadersBase Area80 cm x 46 cm57,5 cm x 51 cm57,5 cm x 51 cm
Predicate Devices:GammaMedplus iX Series HDR Afterloaders (K071381) andNucletron MicroSelectron V3 (K061354).Height98 cm - 138 cm105 cm-145 cm105 cm-145 cm
Device Description:The GammaMedplus iX Series afterloader systems are computercontrolled remote electro/mechanical systems used for medicalpurposes, for placing a cable incorporating an irradiated iridiumseed internally or close by a malignant tumor or tumor bed in apractice known as brachytherapy.
Indications for Use:The GammaMedplus iX™ Series is indicated for use in thetreatment of both benign and malignant disease, for both curativeand palliative intent, in the delivery of High Dose Rate (HDR) andPulsed Dose Rate (PDR) remote-controlled brachytherapy.

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Technological Characteristics:

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NucletronMicroSelectron V3GammaMedplus™ iX,(with ConsoleSoftware version 1.1)GammaMedplus™ iX,(with Console Softwareversion 1.2)
Adjustable heightposition measured inthe center of theindexer90.8cm- 138.0cm90 cm-130 cm90 cm-130 cm
Weight120 kg130 kg130 kg
Transportable (USDOT-7A; Type A)YesYesYes
Power Supply90-130V; 60 Hz, or 190-250V;50 Hz230/115/100V50-60 Hz230/115/100V50-60 Hz
MobileYesYesYes
HDRYesYesYes
PDRYesNoYes for GammaMedplus iXNo for GammaMedplus 3/24 iX
Number of Channels6, 18, 3024 for GammaMedplus iX5 for GammaMedplus 3/24iX24 for GammaMedplus iX5 for GammaMedplus 3/24 iX
ShieldingTungsten.TungstenTungsten
Maximum shieldingactivity518 GBq / 14 Ci555 GBq / 15 Ci555 GBq / 15 Ci
Maximum treatmentactivity518 GBq / 14 Ci555 GBq / 15 Ci555 GBq / 15 Ci
Max. exposure rate at1m distance containingthe maximum activity<0.15 µSv/hr, whencontaining a 10 Ci source0.3 mrem/hr(3 µSv/hr)0.3 mrem/hr(3 µSv/hr)
Dwell positions pereach channel486060
Area radiation monitor(integrated GMcounter)YesYesYes
Maintained treatmentdata during powerfailure (batterypowered RAM)YesYesYes
Simulator sourceYesYesYes
Verification of channellengthNoYesYes

and the comments of the comments of the comments of

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NucletronMicroSelectron V3GammaMedplus™ iX,(with ConsoleSoftware version 1.1)GammaMedplus™ iX,(with Console Softwareversion 1.2)
Verification ofapplicator connectionNoYes*Yes
Source positioningProximal to distalDistal to proximalDistal to proximal
Max. source positionerror over treatmentlength+/- 1mm per position0.35 % referring to 600 mm0.35 % referring to 600 mm
Emergency containerfor the sourceYesYesYes
Response toemergency signalAutomatic source retractionAutomatic source retractionAutomatic source retraction
Emergency manualretractionYesYesYes
IsotopeIr-192Ir-192Ir-192
Source
Maximum activity518 GBq / 14 Ci555 GBq / 15 Ci555 GBq / 15 Ci
Maximum treatmentactivity518 GBq / 14 Ci555 GBq / 15 Ci555 GBq / 15 Ci
Capsule dimensions(length x Ø)4,50 x 0.9 mm4,52 x 0.9 mm4,52 x 0.9 mm
Active dimensions(length x Ø)3,5 x 0.6 mm3,5 x 0.6 mm3,5 x 0.6 mm
Source extensionlength1500 mm1300 mm1300 mm
Operator console
Operating console withPersonal Computer andPrinterYesYesYes
Keyswitch controlYesYesYes

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and the control control control control controllers and

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NucletronGammaMedplus™ iX,GammaMedplus™ iX,
MicroSelectron V3(with ConsoleSoftware version 1.1)(with Console Softwareversion 1.2)
Control SoftwaremicroSelectron™Treatment ControlSoftwareiX Console SoftwareVersion 1.1iX Console SoftwareVersion 1.2
Plan ImportAbility to import data fromNucletron brachytherapytreatment planning systems.Ability to accept treatmentplans from any planningsystem that produces planscomplying with the definedformat.Ability to automatically recordsome treatment status/historywith Aria patient managementsystem (Console softwareversion 1.1)
Ability to export treatmentdelivery data via a DICOMtreatment delivery record.(Console software version 1.2)
Plan CreationAvailableAvailableAvailable
Source DecayCalculationOnce dailyOnce dailyOnce daily
Error ReportingError code or status messagesdisplayed in text,accompanied by an indicationof the action required.Error code or statusmessages displayed in text,accompanied by anindication of the actionrequired.Error code or status messagesdisplayed in text, accompaniedby an indication of the actionrequired.
Report GenerationTreatment report includes anoverview of all treatment-related information.Treatment report includes anoverview of all treatment-related information.Treatment report includes anoverview of all treatment-related information.
Plan EditingDwell positions may beprogrammed manually.Dwell positions may beprogrammed manuallyDwell positions may beprogrammed manually
Full-Screen OperationNo full screenDisallows access to windowsoperating system.Disallows access to windowsoperating system
WorkflowsWorkflow-based treatmentdeliveryWorkflow-based treatmentdelivery.Workflow-based treatmentdelivery
SecurityKey and password protectedPassword-based user access.Password-based user access.
Physics Test PlansSupport for physics test plansSupport for physics testplansSupport for physics test plans
Startup ChecksAutomatic self-test whenTreatment Control System isStartup checksStartup checks

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NucletronMicroSelectron V3GammaMedplus™ iX,(with ConsoleSoftware version 1.1)GammaMedplus™ iX,(with Console Softwareversion 1.2)
Service AccessService-only access mode,with features for adjustingcertain parameters on theafterloader directly from theconsole.Service-only access mode,with features for adjustingcertain parameters on theafterloader directly from theconsole.Service-only access mode, withfeatures for adjusting certainparameters on the afterloaderdirectly from the console.
User Access RightsSystem access can becustomized for specificauthorization.Privilege-based user accessrights, for multiple users.Privilege-based user accessrights, for multiple users
Patient PrivacyHas several features forprotecting patient privacy,including encryption ofpatient identificationinformation and datadisclosure reporting.Has several features forprotecting patient privacy,including encryption ofpatient identificationinformation and datadisclosure reporting.Has several features forprotecting patient privacy,including encryption of patientidentification information anddata disclosure reporting
System Data DisplayContinuous display of criticalsystem data, includingpending errors, remainingwire cycles, days since lastsource exchange, and most-recently calculated sourcestrength.Continuous display of criticalsystem data, includingpending errors, remainingwire cycles, days since lastsource exchange, and most-recently calculated sourcestrength.Continuous display of criticalsystem data, including pendingerrors, remaining wire cycles,days since last sourceexchange, and most-recentlycalculated source strength.
Error / Event LoggingSystem logbook can bedisplayed by date, code, andtype.Log of all recent systemerrors and events.Log of all recent system errorsand events.
Partial TreatmentOptionsPartial treatment optionsPartial treatment optionsRemoved "redistributeundelivered portion" partialtreatment option.
Error MessageAnnotationEach system message can becustomized to user'srequirements.Error message annotation,for site-specific errorrecovery actions.Error message annotation, forsite-specific error recoveryactions.
Fraction EditingSupport for fraction addingand modificationSupport for fraction addingand modificationDisallowed if the fractioncontains dose information.
Standard PlansSupport for standard plansSupport for standard plansSupport for standard plans
Console Data BackupDatabase backup andretrievalManual and automaticconsole data backup options.Manual and automatic consoledata backup options.
Applicator DefinitionBasic applicator definition,including number ofchannels, channel names,and channel lengths.Basic applicator definition,including number ofchannels, channel names,and channel lengths.Basic applicator definition,including number of channels,channel names, and channellengths.

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NucletronMicroSelectron V3GammaMedplusTM iX,(with ConsoleSoftware version 1.1)GammaMedplusTM iX,(with Console Softwareversion 1.2)
Source ExchangeRecordSource information recorded,including date of lastexchange, and number ofsource transfers.On-going record of all sourceexchanges, including date,strength, and number ofcycles.On-going record of all sourceexchanges, including date,strength, and number ofcycles.
Remote service accessNot availableNot availableAllows Varian serviceengineers to log into theconsole remotely.
  • Channels 20 to 24 of the GammaMedplus iX and channels 23 and 24 of the GammaMedplus 3/24 iX do not verify the applicator connection. These channels support use of the GammaMedplus 3/24 with applicators that may not withstand the force of the push test.

Non Clinical Tests For each device, in every mode of use, a full set of verification tests were performed on every pertinent aspect of the software and hardware to determine the safe functioning of the device. Clinical Tests No Clinical tests have been included in this pre-market submission. All the tests that were performed met the applied pass criteria. Varian considers the device to be safe Conclusions

and effective and to perform as well or better than the predicate.

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Image /page/7/Picture/0 description: The image shows the logo for the Department of Health & Human Services USA. The logo features a stylized eagle with three lines representing its body and wings. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" is arranged in a circular pattern around the eagle.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

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

JUL 26 2012

Ms. Vy Tran Vice President, Regulatory Affairs and Quality Systems Varian Medical Systems, Inc 3100 Hansen Way PALO ALTO CA 94304

Re: K120993

Trade/Device Name: GammaMedplus iX and GammaMedplus 3/24 iX afterloaders (GammaMedplus iX™ Series Brachytherapy Afterloaders). Regulation Number: 21 CFR 892.5700 Regulation Name: Remote controlled radionuclide applicator system Regulatory Class: II Product Code: JAQ Dated: June 18, 2012 Received: June 20, 2012

Dear Ms. Tran:

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 i comply with all the Act's requirements, including, but not limited to: registration and listing (21 ። CFR Parts 807); labeling'(21-CFR Parts 801 and 809); medical device reporting (reporting-of ዓፖሊ ነች።

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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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Indications for Use Form

510(k) Number (if known):

Device Name: GammaMedplus iX and GammaMedplus 3/24 iX afterloaders (GammaMedplus iX™ Series Brachytherapy Afterloaders).

Indications for Use:

The GammaMedplus iX™ Series is indicated for use in the treatment of both benign and malignant disease, for both curative and palliative intent, in the delivery of High Dose Rate (HDR) and Pulsed Dose Rate (PDR)remotecontrolled brachytherapy.

Prescription Use __ X (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 OF NEEDED)

Concurrence of CDRH, Office of In Vitro Diagnostic Devices (OIVD)

Division Sign Off

Sign-Off Office of In Vitro Diagnostic Device

Page 1 of 1

§ 892.5700 Remote controlled radionuclide applicator system.

(a)
Identification. A remote controlled radionuclide applicator system is an electromechanical or pneumatic device intended to enable an operator to apply, by remote control, a radionuclide source into the body or to the surface of the body for radiation therapy. This generic type of device may include patient and equipment supports, component parts, treatment planning computer programs, and accessories.(b)
Classification. Class II.