K Number
K130935
Device Name
DIGITAL FLAT PANEL X-RAY DETECTOR/1417WCA
Manufacturer
Date Cleared
2013-07-02

(89 days)

Product Code
Regulation Number
892.1680
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
1417WCA Digital Flat Panel X-Ray Detector is indicated for digital imaging solution designed for general radiographic system for human anatomy. It is intended to replace film or screen based radiographic systems in all general purpose diagnostic procedures. Not to be used for mammography.
Device Description
1417WCA is a wired/wireless digital X-ray flat panel detector that can acquire radiographic images of human anatomy when used with existing radiographic x-ray systems. The wireless LAN((IEEE 802.11a/g/n) communication signals images captured to the system and improves the user operability through high-speed processing. This X-ray imaging detector consists of a scintillator directly coupled to an a-Si TFT sensor. 1417WCA is designed specifically to be integrated with a console PC system and X-Ray generator to digitalize x-ray images into RAW files. The RAW files can be made to DICOM compatible image files which can be viewed by console SW for a radiographic image diagnosis and analysis.
More Information

Not Found

No
The summary describes a digital X-ray detector and its image acquisition and processing capabilities, but there is no mention of AI or ML being used for image analysis, interpretation, or any other function. The performance studies focus on standard imaging metrics (MTF, DQE, NPS) and clinical image review by a radiologist, not on the performance of an AI/ML algorithm.

No
This device is an X-ray detector used for diagnostic imaging, not for treating diseases or conditions.

Yes

Explanation: The device is an X-ray detector used for acquiring radiographic images for diagnostic purposes, which is a key step in diagnosing medical conditions. The "Intended Use" states it is "designed for general radiographic system for human anatomy" and "intended to replace film or screen based radiographic systems in all general purpose diagnostic procedures." The "Device Description" also mentions the ability to "viewed by console SW for a radiographic image diagnosis and analysis." This indicates its role in the diagnostic process.

No

The device description clearly states it is a "wired/wireless digital X-ray flat panel detector" and describes physical components like a scintillator and a-Si TFT sensor, indicating it is a hardware device with integrated software.

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

Here's why:

  • Intended Use: The intended use clearly states it's for "digital imaging solution designed for general radiographic system for human anatomy." This involves imaging the human body directly, not testing samples taken from the body (which is the core of in vitro diagnostics).
  • Device Description: The description details a digital X-ray flat panel detector that acquires radiographic images of human anatomy. This is consistent with in vivo imaging, not in vitro testing.
  • Input Imaging Modality: The input modality is X-ray, which is used for imaging the body, not for analyzing biological samples.

IVD devices are used to examine specimens such as blood, urine, or tissue to detect diseases, conditions, or infections. This device is used to create images of the internal structures of the human body.

N/A

Intended Use / Indications for Use

1417WCA Digital Flat Panel X-Ray Detector is indicated for digital imaging solution designed for general radiographic system for human anatomy. It is intended to replace film or screen based radiographic systems in all general purpose diagnostic procedures. Not to be used for mammography.

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

MQB

Device Description

1417WCA is a wired/wireless digital X-ray flat panel detector that can acquire radiographic images of human anatomy when used with existing radiographic x-ray systems. The wireless LAN((IEEE 802.11a/g/n) communication signals images captured to the system and improves the user operability through high-speed processing. This X-ray imaging detector consists of a scintillator directly coupled to an a-Si TFT sensor. 1417WCA is designed specifically to be integrated with a console PC system and X-Ray generator to digitalize x-ray images into RAW files. The RAW files can be made to DICOM compatible image files which can be viewed by console SW for a radiographic image diagnosis and analysis.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

X-ray

Anatomical Site

human anatomy

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

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 non-clinical test report and clinical consideration report were prepared and submitted to FDA separately to demonstrate the substantial equivalency between two different detectors. The non-clinical test report contains the MTF, DQE and NPS test results of 1417WCA and 1417PCA by using the identical test equipment and same analysis method described by IEC 62220-1 The comparisoin of the MTF for 1417WCA and 1417PCA detector demonstated that the MTF of the 1417WCA detector performed almost same with 1417PCA. Therefore the overall resolution performance and shapness of 1417WCA is almost same with 1417PCA. The DQE represents the ability to visualize object details of a certain size and contrast. 1417WCA demonstrated almost same DQE performance with 1417PCA at various spatial frequencies and provides almost same Signal-toNoise Ratio (SNR) transfer from the input to the output of a detector as a function of frequency. At the lowest spatial frequency, the DQE test for 1417WCA and 1417 PCA resulted 74%, respectively. The NPS test for 1417WCA and 1417 PCA exhibited almost identical performance between the two devices. Therefore, the image quality of 1417WCA is substantially equivalent to 1417PCA at the same patient exposure setting.

To further demonstrate the substantial equivalency of two devices, clinical images are obtained from both devcies and reviewd by a licensed US radiologist to render an expert opinion. Both the test (1417WCA) and control group (1417PCA) are evaluated according to similar age group and anatomical structures were compared in accordance with the test protocol of diagnostic radiography evaluation procedure.

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.

K122919

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

§ 892.1680 Stationary x-ray system.

(a)
Identification. A stationary x-ray system is a permanently installed diagnostic system intended to generate and control x-rays for examination of various anatomical regions. This generic type of device may include signal analysis and display equipment, patient and equipment supports, component parts, and accessories.(b)
Classification. Class II (special controls). A radiographic contrast tray or radiology diagnostic kit intended for use with a stationary x-ray system only is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 892.9.

0

K130935
Page 1 of 5
Rev. 3

510(k) Summary

JUL 0 2 2013

This summary of 510(k) safety and effectiveness information is being submitted in accordance with requirements of 21 CFR Part 807.92.

Date 510K summary prepared: March 26, 2013

Submitter's Name, address, telephone number, a contact person:

Submitter's Name :Rayence Co., Ltd.
Submitter's Address:1F, 2F, 3F, #402, 14, Samsung 1-ro 1-gil,
Hwaseong-si, Gyeonggi-do, Korea
Submitter's Telephone:+82-31-8015-6459
Contact person:Mr. Kee Dock Kim / Manager
Official Correspondent:Dave Kim (davekim@mtech-inc.net)
(U.S. Designated agent)
Address:12946 Kimberley Ln, Houston, TX 77079
Telephone:+713-467-2607
Fax:+713-464-8880

Name of the device, including the trade or proprietary name if applicable, the common or usual name and the classification name, if known:

Trade/proprietary name:1417WCA
Common Name:Digital Flat Panel X-ray Detector
Classification Name :21CFR892.1680 / Stationary x-ray system
Product Code:MQB

1

1

Predicate Device :

Manufacturer: Rayence Co., Ltd.
Device: 1417PCA
510(k) Number: K122919 (Decision Date - JAN. 31. 2013)

Device Description :

1417WCA is a wired/wireless digital X-ray flat panel detector that can acquire radiographic images of human anatomy when used with existing radiographic x-ray systems. The wireless LAN((IEEE 802.11a/g/n) communication signals images captured to the system and improves the user operability through high-speed processing. This X-ray imaging detector consists of a scintillator directly coupled to an a-Si TFT sensor. 1417WCA is designed specifically to be integrated with a console PC system and X-Ray generator to digitalize x-ray images into RAW files. The RAW files can be made to DICOM compatible image files which can be viewed by console SW for a radiographic image diagnosis and analysis.

Indication for use :

1417WCA Digital Flat Panel X-Ray Detector is indicated for digital imaging solution designed for general radiographic system for human anatomy. It is intended to replace film or screen based radiographic systems in all general purpose diagnostic procedures. Not to be used for mammography.

Summary of the technological characteristics of the device compared to the predicate device:

The 1417WCA SSXI detector described in this 510(k) has the same indications for use and similar technical characteristics as its predicate device, 1417PCA flat panel detector, of Rayence Co., Ltd. Table 1 summarizes the technological characteristics of the 1417WCA and 1417PCA, the predicate device.

2

| Characteristic | Proposed
Rayence Co.,Ltd.
1417WCA | Predicate
Rayence Co.,Ltd.
1417PCA |
|-----------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 510(k) number | - | -K122919 |
| Intended Use | 1417WCA Digital Flat Panel X-Ray Detector is indicated for
digital imaging solution designed
for general radiographic system
for human anatomy. It is intended
to replace film or screen based
radiographic systems in all
general purpose diagnostic
procedures. Not to be used for
mammography. | 1417PCA Digital Flat Panel X-Ray Detector is indicated for
digital imaging solution designed
for general radiographic system
for human anatomy. It is intended
to replace film or screen based
radiographic systems in all
general purpose diagnostic
procedures. Not to be used for
mammography. |
| Detector Type | Amorphous Silicon, TFT | Amorphous Silicon, TFT |
| Scintillator | Cesium Iodide | Cesium Iodide |
| Imaging Area | 14 x 17 inches | 14 x 17 inches |
| Total Pixel
Number | 3328 x 2816 pixels | 3328 x 2816 pixels |
| Pixel pitch | 127 µm | 127 µm |
| Resolution | 3.9 lp/mm | 3.9lp/mm |
| A/D conversion | 14 bit | 14 bit |
| Preview Image | 23 seconds (wired)
/ 3
5 seconds (wireless) | 2~3 seconds |
| Data output | RAW
*The RAW files are
convertible into DICOM 3.0
by console S/W | RAW
*The RAW files are
convertible into DICOM 3.0
by console S/W |
| Dimensions | 460 x 417 x 15.9 mm | 460 x 417 x 15.9 mm |

Table 1: Comparison of 1417WCA and 1417PCA

3

:

3

Weight3.9 kg (incl. battery pack)3.6 kg
ApplicationWireless portable system
Available with upright stand,
table, universal standPortable system
Available with upright stand,
table, universal stand
FeatureImage: X-ray detector with handle on topImage: X-ray detector with handle on top and crosshair in the center

Table 2: Size Comparison of 1417WCA and 1417PCA

ItemUnit1417WCA1417PCA
Pixel Pitchμm127 x 127127 x 127
Total Pixel Numberpixels3328 x 28163328 x 2816
Effective Pixel Areamm415 x 350415 x 350
Effective Pixel Number(light
sensitive)pixels3268x 27563268x 2756
Fill factor%61.0361.03
WeightKg3.9 Kg3.6 Kg

Summary of Performance Testing:

The wireless/wired 1417WCA flat panel detector is a modified version of 1417PCA (K122919), FDA cleared predicate device from Rayence. Indications for use, material, form factor, performance, and safety characteristics between 1417WCA and 1417PCA are the same. The non-clinical test report and clinical consideration report were prepared and submitted to FDA separately to demonstrate the substantial equivalency between two different detectors. The non-clinical test report contains the MTF, DQE and NPS test results of 1417WCA and 1417PCA by using the identical test equipment and same analysis method described by IEC 62220-1 The comparisoin of the MTF for 1417WCA and 1417PCA detector demonstated that the MTF of the 1417WCA detector performed almost same with 1417PCA. Therefore the overall resolution performance and shapness of 1417WCA is almost same with 1417PCA. The DQE represents the ability to visualize object details of a certain size and contrast. 1417WCA demonstrated almost same DQE

4

Image /page/4/Picture/1 description: The image shows handwritten text on a white background. The text includes the identifier "K130935" at the top, followed by "Page 5 of 5" in a cursive style. Below the page number, the text "Rev.3" is present, indicating a revision number.

performance with 1417PCA at various spatial frequencies and provides almost same Signal-toNoise Ratio (SNR) transfer from the input to the output of a detector as a function of frequency. At the lowest spatial frequency, the DQE test for 1417WCA and 1417 PCA resulted 74%, respectively. The NPS test for 1417WCA and 1417 PCA exhibited almost identical performance between the two devices. Therefore, the image quality of 1417WCA is substantially equivalent to 1417PCA at the same patient exposure setting.

To further demonstrate the substantial equivalency of two devices, clinical images are obtained from both devcies and reviewd by a licensed US radiologist to render an expert opinion. Both the test (1417WCA) and control group (1417PCA) are evaluated according to similar age group and anatomical structures were compared in accordance with the test protocol of diagnostic radiography evaluation procedure.

Based on the non-clinical and clinical consideration test and the outcome of a comparative review by an expert for both devices, we can claim the substantial equivalency between 1417WCA and its predicate device, 1417PCA in terms of image quality.

Safety, EMC and Performance Data :

Electrical, mechanical, environmental safety and performance testing according to standard IEC 60601-1:1988 + A1:1991 + A2:1995 (Medical electrical equipment Part 1: General Requirements for Safety) was performed, and EMC testing were conducted in accordance with standard IEC60601-1-2:2007 (CISPR 11:2009/A1: 2010), EN60601-1-2:2007 +A1:2010 (Medical electrical equipment - Part 1-2: General Requirements for safety - Collateral Standard : Electromagnetic Compatibility Requirements and tests). The equipment also complies with the standard FCC Rule part(s) 47CFR PART 15.107(B) / 47CFR PART 15.109(G) CLASSB. All test results were satisfactory.

Conclusions :

In accordance with the Federal Food. Drug and Cosmetic Act, 21 CFR Part 807 and based on the information provided in this premarket notification Rayence Co., Ltd, concludes that 1417WCA is safe and effective and substantially equivalent in comparison with 1417PCA, the predicate device as described herein.

5

Image /page/5/Picture/0 description: The image shows a partial view of a document or logo. On the left, there's a stylized graphic with curved lines, possibly part of a circular design. To the right, the word "DEPARTMENT" is printed in a clear, sans-serif font. A horizontal line is present beneath the word, suggesting it might be a heading or part of a formal document.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20003-0002

July 2. 2013

Ravence Co., Ltd. % Mr. Dave Kim Medical Device Regulatory Affairs Mtech Group 12946 Kimberley Lane HOUSTON TX 77079

Re: K130935

Trade/Device Name: Digital Flat Panel X-ray Detector / 1417WCA Regulation Number: 21 CFR 892.1680 Regulation Name: Stationary x-ray system Regulatory Class: II Product Code: MQB Dated: April 04, 2013 Received: April 04, 2013

Dear Mr. Kim:

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 Mav 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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA). it may be subject to 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): medical device reporting of medical device-related adverse events) (21 CFR 803); 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.

6

Page 2 - Mr. Kim

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Small Manufacturers, International and Consumer Assistance at its tollfree number (800) 638 2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR 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/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours,

Janning M. Menge

Janine M. Morris Director, Division of Radiological Health Office of In Vitro Diagnostics and Radiological Health Center for Devices and Radiological Health

Enclosure

7

Indications for Use

510(k) Number (if known): K130935

Device Name: Digital Flat Panel X-ray Detector / 1417 WCA

Indications for Use:

1417WCA Digital Flat Panel X-Ray Detector is indicated for digital imaging solution designed for general radiographic system for human anatomy. It is intended to replace film or screen based radiographic systems in all general purpose diagnostic procedures. Not to be used for mammography.

Prescription Use (Part 21 CFR 801 Subpart D)

AND/OR

Over-The-Counter Use (21 CFR 807 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

Stamford M. Weiss

(Division Sign Off) Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health

510(k) K 130935

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