K Number
K121934
Device Name
TOMOTHERAPY TREATMENT SYSTEM
Date Cleared
2012-08-29

(58 days)

Product Code
Regulation Number
892.5050
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The TomoTherapy Treatment System is intended to be used as an integrated system for the planning and precise delivery of radiation therapy, stereotactic radiotherapy, or stereotactic radiosurgery to tumors or other targeted tissues while minimizing the delivery of radiation to vital healthy tissue. The megavoltage x-ray radiation is delivered in a rotational, non-rotational, modulated (IMRT), or non-modulated (non-IMRT/three dimensional conformal) format in accordance with the physician approved plan.
Device Description
The TomoTherapy Treatment System is a radiation therapy system that integrates planning, dose calculation, megavoltage CT imaging for IGRT functionality, and helical (rotational) and fixed beam (non-rotational) radiation therapy treatment capabilities into a single comprehensive system. The TomoTherapy Treatment System is a prescription device. It delivers radiation in accordance with a physician approved plan. The device does not diagnose disease, recommend treatment regimens, or quantify treatment effectiveness. The megavoltage CT imaging functionality is not intended for diagnostic use.
More Information

Not Found

No
The document explicitly states "Mentions AI, DNN, or ML: Not Found" and the description focuses on traditional radiation therapy planning and delivery methods.

Yes
The device is described as a system for the "precise delivery of radiation therapy, stereotactic radiotherapy, or stereotactic radiosurgery to tumors or other targeted tissues," which are all forms of medical treatment.

No

The "Device Description" explicitly states, "The device does not diagnose disease," and "The megavoltage CT imaging functionality is not intended for diagnostic use."

No

The device description explicitly states it is a "radiation therapy system" that integrates planning, dose calculation, imaging, and radiation delivery capabilities, indicating it includes significant hardware components beyond just software.

Based on the provided information, the TomoTherapy Treatment System is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is for the planning and delivery of radiation therapy to treat tumors or targeted tissues. This is a therapeutic intervention, not a diagnostic test performed on samples taken from the body.
  • Device Description: The description explicitly states that the device "does not diagnose disease, recommend treatment regimens, or quantify treatment effectiveness." It is a treatment delivery system.
  • IVD Definition: In vitro diagnostics are tests performed on samples (like blood, urine, tissue) taken from the human body to provide information about a person's health. The TomoTherapy system does not perform such tests.

While the system uses imaging (megavoltage CT) for treatment planning and guidance (IGRT), this imaging is for the purpose of delivering the therapy accurately, not for diagnosing a condition from a sample.

N/A

Intended Use / Indications for Use

The TomoTherapy Treatment System is intended to be used as an integrated system for the planning and precise delivery of radiation therapy, stereotactic radiotherapy, or stereotactic radiosurgery to tumors or other targeted tissues while minimizing the delivery of radiation to vital healthy tissue. The megavoltage x-ray radiation is delivered in a rotational, non-rotational, modulated (IMRT), or non-modulated (non-IMRT/three dimensional conformal) format in accordance with the physician approved plan.

Product codes

MUJ, IYE

Device Description

The TomoTherapy Treatment System is a radiation therapy system that integrates planning, dose calculation, megavoltage CT imaging for IGRT functionality, and helical (rotational) and fixed beam (non-rotational) radiation therapy treatment capabilities into a single comprehensive system.

The TomoTherapy Treatment System is a prescription device. It delivers radiation in accordance with a physician approved plan. The device does not diagnose disease, recommend treatment regimens, or quantify treatment effectiveness. The megavoltage CT imaging functionality is not intended for diagnostic use.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

megavoltage CT imaging

Anatomical Site

tumors or other targeted tissues

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Prescription Use

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)

The TomoTherapy Treatment System was tested and shown to be in compliance with the requirements of applicable recognized consensus safety standards for medical devices. Results of verification and validation testing confirm the TomoTherapy Treatment System conforms to design specifications and meets the needs of the intended users. No clinical tests were required to establish substantial equivalence. The performance data demonstrate the TomoTherapy Treatment System is as safe, as effective, and performs as well as the predicate device.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K112776

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 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.

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K121934

ACCURAY®

TomoTherapy* A wholly owned subsidiary of Accuray

510(k) Summary Section 2

AUG 2 9 2012

Applicant:

Accuray Incorporated 1240 Deming Way Madison, WI 53717-1954 Phone: 608.824.2800 Fax: 608.824.2981

Contact:Gregory G. Bange
Date Prepared:June 29, 2012

Device Identification:

Device Name:TomoTherapy Treatment System
Trade & Brand Names:Hi-Art® and TomoHDTM
Common Name:Radiation Therapy System
Classification:System, Planning, Radiation Therapy Treatment
Product Code:MUJ
Regulation Number:21 CFR 892.5050
Regulation Description:Medical charged particle radiation therapy system

Predicate Device:

TomoTherapy Treatment System (K112776)

Description:

The TomoTherapy Treatment System is a radiation therapy system that integrates planning, dose calculation, megavoltage CT imaging for IGRT functionality, and helical (rotational) and fixed beam (non-rotational) radiation therapy treatment capabilities into a single comprehensive system.

The TomoTherapy Treatment System is a prescription device. It delivers radiation in accordance with a physician approved plan. The device does not diagnose disease, recommend treatment regimens, or quantify treatment effectiveness. The megavoltage CT imaging functionality is not intended for diagnostic use.

Intended Use:

The TomoTherapy Treatment System is intended to be used as an integrated system for the planning and precise delivery of radiation therapy, stereotactic radiotherapy, or stereotactic radiosurgery to tumors or other targeted tissues while minimizing the delivery of radiation to vital healthy tissue. The megavoltage x-ray radiation is delivered in a rotational, non-rotational, (IMRT), or non-modulated (non-IMRT/three dimensional modulated conformal) format in accordance with the physician approved plan.

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Technological Characteristics:

The technological characteristics of the TomoTherapy Treatment System are substantially equivalent to the predicate. The physical properties of the device are identical to the predicate. Enhancements to software allow for the planning and delivery of radiation therapy that utilize asymmetric positions and dynamic motion of the primary beam limiting device.

Performance Data:

The TomoTherapy Treatment System was tested and shown to be in compliance with the requirements of applicable recognized consensus safety standards for medical devices. Results of verification and validation testing confirm the TomoTherapy Treatment System conforms to design specifications and meets the needs of the intended users. No clinical tests were required to establish substantial equivalence. The performance data demonstrate the TomoTherapy Treatment System is as safe, as effective, and performs as well as the predicate device.

Summary:

The TomoTherapy Treatment System is substantially equivalent to the predicate device. The intended use, major technological characteristics, and the principles of operation of the TomoTherapy Treatment System are identical to those of the predicate device. Minor technological differences do not raise new types of safety or effectiveness questions. Performance data demonstrate the TomoTherapy Treatment System is as safe, as effective, and performs as well as the predicate device.

2

Image /page/2/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is circular and contains the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. In the center of the circle is an abstract symbol that resembles an eagle or bird in flight, composed of three curved lines.

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

AUG 2 9 2012

Mr. Gregory G. Bange Manager of Regulatory Submissions and Standards Accuray Incorporated 1209 Deming Way MADISON WI 53717

Re: K121934

Trade/Device Name: TomoTherapy Treatment System Regulation Number: 21 CFR 892.5050 Regulation Name: Medical charged-particle radiation therapy system Regulatory Class: II Product Code: IYE and MUJ Dated: June 29, 2012 Received: July 2, 2012

Dear Mr. Bange:

We have reviewed your Section 510(k) premarket notification of intent to market the device we nave reviewed your becally be device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate for use surfed in the encreativent of the enactment date of the Medical Device Amendments, or to conimered print to May 20, 1978, in occordance 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 r ou may, distore, mains 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 If your device Is classified (300 a00 regulations affecting your device can be found in Title 21, additions: Controls: Existing major 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 Flease be advised that I DA 3 issumes or a race complies with other requirements of the Act that IDA has made a dolormistion and regulations administered by other Federal agencies. You must of any I cuchares and regaratis including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Parts 801 and 809); medical device reporting (reporting of

3

medical device-related adverse events) (21 CFR 803); and good manufacturing practice mourements as set forth in the quality systems (QS) regulation (21 CFR Part 820). This letter requirements as set form in the quality of since & described in your Section 510(k) premarket will anow you to begin mading of substantial equivalence of your device to a legally marketed notification. The I Drivin 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 If you desire specific ad rice tor your live Diagnostic Device Evaluation and Safety at (301) 796-5450. Also, please note the regulation entitled, "Misbranding by reference to premarket 9 150. Thise 1100, premo 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 Tou may 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

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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Section 1 Indications for Use Form

510(k) Number (if known): K121934

Device Name:

TomoTherapy Treatment System

Indications for use:

The TomoTherapy Treatment System is intended to be used as an integrated system for the planning and precise delivery of radiation therapy, stereotactic radiotherapy, or stereotactic radiosurgery to tumors or other targeted tissues while minimizing the delivery of radiation to vital The megavoltage x-ray radiation is delivered in a healthy tissue. rotational, non-rotational, modulated (IMRT), or non-modulated (non-IMRT/three dimensional conformal) format in accordance with the physician approved plan.

Prescription Use X (Per 21 CFR 801 subpart D) AND/OR

Over-the-Counter Use (Per 21 CFR 801 subpart C)

PLEASE DO NOT WRITE BELOW THIS LINE. CONTINUE ON ANOTHER PAGE IF NEEDED.

Concurrence of CDRH, Office of In-Vitro Diagnostics (OIVD)

Division Sign Off

Division Sign-Off Office of In-Vitro Diagnostic Device Evaluation and Safety

510(k) Kia1934

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