K Number
K131075
Device Name
X-RAY TV SYSTEM SONIAL VISION G4
Manufacturer
Date Cleared
2014-03-28

(345 days)

Product Code
Regulation Number
892.1650
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
- -The SONIALVISION G4 is intended to be used for the fluoroscopy/radiography diagnosis in hospital. - The equipment must only be operated by qualified personnel, such as radiography technicians or those with equivalent qualifications. - The system is used for total patient population. - This system is NOT intended to be used for Mammography screening. - This system is NOT intended to be used for interventional procedure. - This system is used for radiographic, fluoroscopic, angiographic and pediatric examinations. - Stored images in this system can be used for re-monitoring, image processing, storing to optical media (CD/DVD), and sending to DICOM server.
Device Description
The Shimadzu SONIALVISION G4 is a universal X-ray RF system offering radiographic, fluoroscopic and angiographic techniques. The Shimadzu SONIALVISION G4 is floor mounted table, and the system can be configured with Digital Radiography System, X-ray High Voltage Generator, Collimator and X-ray Tube.
More Information

Not Found

No
The document mentions "image processing" but does not contain any explicit mentions of AI, ML, deep learning, or related terms. The performance studies described are standard for medical imaging devices and do not indicate the use of AI/ML algorithms for image analysis or interpretation.

No
The device is described as being used for "fluoroscopy/radiography diagnosis" and "radiographic, fluoroscopic, angiographic and pediatric examinations," which are diagnostic rather than therapeutic purposes.

Yes

Explanation: The "Intended Use / Indications for Use" section explicitly states "The SONIALVISION G4 is intended to be used for the fluoroscopy/radiography diagnosis in hospital." This directly indicates its purpose as a diagnostic device.

No

The device description clearly states it is a "universal X-ray RF system" and includes hardware components such as a floor-mounted table, Digital Radiography System, X-ray High Voltage Generator, Collimator, and X-ray Tube. While it includes software for image processing and storage, it is not solely software.

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

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections.
  • Device Function: The SONIALVISION G4 is an X-ray system used for imaging the inside of the body (fluoroscopy and radiography). It uses X-rays to create images, not to analyze biological samples.
  • Intended Use: The intended use clearly states "fluoroscopy/radiography diagnosis," which is an imaging-based diagnostic method, not an in vitro test.
  • Device Description: The description details the components of an X-ray system (X-ray tube, generator, collimator, detector), not equipment for analyzing biological samples.

Therefore, the SONIALVISION G4 falls under the category of medical imaging devices, not in vitro diagnostics.

N/A

Intended Use / Indications for Use

The SONIALVISION G4 is intended to be used for the fluoroscopy and radiography diagnosis. This system is operated and used by the physicians and X-ray technologist in a hospital. The system is used for total patient population. This system is used for radiographic, fluoroscopic, angiographic and pediatric examinations.

The SONIALVISION G4 is intended to be used for the fluoroscopy/radiography diagnosis in hospital. The equipment must only be operated by qualified personnel, such as radiography technicians or those with equivalent qualifications.

The system is used for total patient population. This system is NOT intended to be used for Mammography screening. This system is NOT intended to be used for interventional procedure. This system is used for radiographic, fluoroscopic, angiographic and pediatric examinations. Stored images in this system can be used for re-monitoring, image processing, storing to optical media (CD/DVD), and sending to DICOM server.

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

90 JAA

Device Description

The Shimadzu SONIALVISION G4 is a universal X-ray RF system offering radiographic, fluoroscopic and angiographic techniques. The Shimadzu SONIALVISION G4 is floor mounted table, and the system can be configured with Digital Radiography System, X-ray High Voltage Generator, Collimator and X-ray Tube.

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

X-ray

Anatomical Site

Not Found

Indicated Patient Age Range

total patient population

Intended User / Care Setting

physicians and X-ray technologist in a hospital.
qualified personnel, such as radiography technicians or those with equivalent qualifications.

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)

Non-clinical performance testing was performed for the SONIALVISION G4 during product development, which includes verification and validation testing as well as phantom testing. The risk analysis was completed and risk controls implemented to mitigate identified hazards. The testing results support that all the software specifications have fulfilled the acceptance criteria.

The system complies to AAMI/ANSI ES 60601-1:2005, IEC 60601-2-54 Edition 1.0:2009 and other involved standards and applicable performance standards for radiation emitting products of this premarket submission.

We also conducted a performance bench test, comparing with image quality of both predicate device and modified device. Linearity, MTF, DQE and Density resolution of two detectors were measured and we estimated that both have enough performance to acquire X-ray images.

We performed concurrence study of clinical images between subject device and its predicate device, which was reviewed by an U.S. radiologist. The result of overall clinical review confirmed that new device is substantially equivalent to the predicate device in aspect of its diagnostic capability.

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.

K052500

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

§ 892.1650 Image-intensified fluoroscopic x-ray system.

(a)
Identification. An image-intensified fluoroscopic x-ray system is a device intended to visualize anatomical structures by converting a pattern of x-radiation into a visible image through electronic amplification. 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). An anthrogram tray or radiology dental tray intended for use with an image-intensified fluoroscopic 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. In addition, when intended as an accessory to the device described in paragraph (a) of this section, the fluoroscopic compression device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 892.9.

0

Image /page/0/Picture/0 description: The image shows the logo for SHIMADZU. To the left of the company name is a black square with a white circle and a plus sign inside. The company name is written in all capital letters and in a bold, sans-serif font. The logo is simple and modern.

510(k) Notification Submission, SONIALVISION G4

MAR 2 8 2014

SECTION V:

510(k) Summary

The following information is submitted in accordance with the requirements of 21 CFR§807.92.

1) Date of Submission

April 2nd, 2013

2) Submitter

SHIMADZU CORPORATION

1, Nishinokyo-Kuwabaracho, Nakagyo-ku, Kyoto city, JAPAN 604-8511 Registration Number: 8030233 Phone: +81-75-823-1305 FAX: +81-75-823-1377

3) Primary Contact Person

Yoshihiro Mukuta Phone: +81-75-823-1305 E-mail: mukuta@shimadzu.co.jp

4) Secondary Contact Person

Don Karle SHIMADZU MEDICAL SYSTEMS 20101 South Vermont Ave., Torrance, CA 90502 Phone: 310-217-8855 ext 109 Email: karle@shimadzu-usa.com

5) The Device Name

Trade NameX-RAY TV SYSTEM SONIALVISION G4
Common NameX-RAY RF SYSTEM
Regulation DescriptionImage-intensified fluoroscopic x-ray system
Classification PanelRadiology
CFR Section21 CFR§892.1650
Device ClassClass II
Product Code90 JAA

6) Legally Marketed Predicate Device

K052500DAR-8000F
--------------------

KBI075
Page 1 of 3

Page 5-1

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Image /page/1/Picture/0 description: The image shows the Shimadzu logo. The logo consists of a square with a white circle and cross inside, followed by the word "SHIMADZU" in bold, black letters. The logo is simple and modern, and the text is easy to read.

510(k) Notification Submission, SONIALVISION G4

SECTION V:

510(k) Summary

7) Description of the Device

The Shimadzu SONIALVISION G4 is a universal X-ray RF system offering radiographic, fluoroscopic and angiographic techniques. The Shimadzu SONIALVISION G4 is floor mounted table, and the system can be configured with Digital Radiography System, X-ray High Voltage Generator, Collimator and X-ray Tube.

8) Intended Use

The SONIALVISION G4 is intended to be used for the fluoroscopy and radiography diagnosis. This system is operated and used by the physicians and X-ray technologist in a hospital. The system is used for total patient population. This system is used for radiographic, fluoroscopic, angiographic and pediatric examinations.

9) Indications for Use

The SONIALVISION G4 is intended to be used for the fluoroscopy/radiography diagnosis in hospital. The equipment must only be operated by qualified personnel, such as radiography technicians or those with equivalent qualifications.

The system is used for total patient population. This system is NOT intended to be used for Mammography screening. This system is NOT intended to be used for interventional procedure. This system is used for radiographic, fluoroscopic, angiographic and pediatric examinations. Stored images in this system can be used for re-monitoring, image processing, storing to optical media (CD/DVD), and sending to DICOM server.

Differences of indications are just additional information for usage, and those do not affect the safety and effectiveness of the device when used as labeled.

10) Technological Characteristics

The fundamental technologies of the SONIALVISION G4 are same as the predicate device. Modification was made in the material of Solid State Detector in the Digital Radiography System, which is similar to the predicate device regarding technical characteristic, performance and intended use. The safety and effectiveness is equivalent to the predicate device.

11) Non-clinical Performance Testing

Non-clinical performance testing was performed for the SONIALVISION G4 during product development, which includes verification and validation testing as well as phantom testing. The risk analysis was completed and risk controls implemented to mitigate identified hazards. The testing results support that all the software specifications have fulfilled the acceptance criteria.

The system complies to AAMI/ANSI ES 60601-1:2005, IEC 60601-2-54 Edition 1.0:2009 and other involved standards and applicable performance standards for radiation emitting products of this premarket submission.

2

Image /page/2/Picture/0 description: The image shows the word "SHIMADZU" in bold, black letters. To the left of the word is a black square with a white circle and cross inside. The font is sans-serif and appears to be a company logo. The background is white.

510(k) Notification Submission, SONIALVISION G4

Page 5-3

SECTION V:

510(k) Summary

We also conducted a performance bench test, comparing with image quality of both predicate device and modified device. Linearity, MTF, DQE and Density resolution of two detectors were measured and we estimated that both have enough performance to acquire X-ray images. ·

12) Clinical Testing

We performed concurrence study of clinical images between subject device and its predicate device, which was reviewed by an U.S. radiologist. The result of overall clinical review confirmed that new device is substantially equivalent to the predicate device in aspect of its diagnostic capability.

13) Conclusion

From the result of nonclinical and clinical testing discussed above, it is our conclusion that the SONIALVISION G4 is substantially equivalent to the commercially available predicate device DAR-8000f, which was cleared on Oct 17, 2005 with K052500.

This device is as safe, as effective, and performs as well as or better than the predicate device.

3

Public Health Service

DEPARTMENT OF HEALTH & HUMAN SERVICES USA

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

March 28, 2014

SHIMADZU CORPORATION % Mr. Don Karle. Manager. Customer Service Shimadzu Medical Systems 20101 South Vermont Avenue TORRANCE CA 90502-1328

Re: K131075

Trade/Device Name: X-RAY TV SYSTEM SONIALVISION G4 Regulation Number: 21 CFR 892.1650. Regulation Name: Image-intensified fluoroscopic x-ray system Regulatory Class: II Product Code: JAA Dated: February 18, 2014 Received: February 21, 2014

Dear Mr. Karle:

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. 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 cither 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 (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.

4

Page 2-Мг. Karle

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/McdicalDevices/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/Industrv/default.htm.

Sincerely yours,

Smh.7)

for

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

Enclosure

5

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

Form Approved: OMB No. 0910-0120 Expiration Date: December 31, 2013 See PRA Statement on last page.

510(k) Number (if known) K131075

Device Name SONIALVISION G4

Indications for Use (Describe)

  • -The SONIALVISION G4 is intended to be used for the fluoroscopy/radiography diagnosis in hospital.

  • The equipment must only be operated by qualified personnel, such as radiography technicians or those with equivalent qualifications.

  • The system is used for total patient population.

  • This system is NOT intended to be used for Mammography screening.

  • This system is NOT intended to be used for interventional procedure.

  • This system is used for radiographic, fluoroscopic, angiographic and pediatric examinations.

  • Stored images in this system can be used for re-monitoring, image processing, storing to optical media (CD/DVD), and sending to DICOM server.

Type of Use (Select one or both, as applicable)

[x] Prescription Use (Part 21 CFR 801 Subpart D)

Over-The-Counter Use (21 CFR 801 Subpart C)

PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.

FOR FDA USE ONLY

Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

FORM FDA 3881 (9/13)