(28 days)
QLAB Quantification Software is a software application package. It is designed to view and quantify image data acquired on Philips Healthcare ultrasound products.
QLAB Quantification software is available either as a stand-alone product that can function on a standard PC, on board a dedicated workstation, or on-board Philips' ultrasound systems. It can be used by trained healthcare professionals for the on-line and off-line review and quantification of ultrasound studies in healthcare facilities/hospitals. The QLAB Quantification software application package is designed to view and quantify image data acquired on Philips ultrasound products. The four modified plug-ins, a2DO, aCMQ , MVN, and Heart Model are applications within Philips QLAB Quantification software.
The provided document (K132165) describes modifications to existing QLAB Quantification software Q-Apps (a2DQ, aCMQ, MVN, and Heart Model). The submission is a special 510(k) and focuses on demonstrating that the modified software maintains the same level of safety and effectiveness as the predicate (unmodified) versions. It does not present a de novo study to establish new acceptance criteria or full device performance metrics beyond confirming equivalence to the predicate.
Therefore, direct responses to some of your questions, particularly those asking for the reported device performance against acceptance criteria or details of a stand-alone study with specific metrics, are not explicitly provided in this type of submission. The document emphasizes verification and validation against the predicate's established performance, rather than setting and meeting entirely new benchmarks.
Here's an attempt to answer your questions based on the provided text, indicating where information is not explicitly stated for this type of submission:
1. A table of acceptance criteria and the reported device performance
The document states: "Verification and Validation testing concluded that the modified QLAB Q-Apps are safe and effective and introduced no new risks." and "Testing performed demonstrated that the QLAB Quantification software with modified Q-Apps meets all defined reliability requirements and performance claims."
This indicates that the acceptance criteria for this special 510(k) were based on demonstrating equivalence in safety, effectiveness, reliability, and performance to the legally marketed predicate devices. Specific quantitative acceptance criteria (e.g., "EF measurement must be within X% of ground truth") and corresponding reported performance values are not detailed in this summary.
| Acceptance Criteria (Implied) | Reported Device Performance (Implied) |
|---|---|
| Maintain safety profile of predicate device | No new risks introduced. |
| Maintain effectiveness profile of predicate device | Safe and effective. |
| Meet established reliability requirements of predicate device | Meets all defined reliability requirements. |
| Meet established performance claims of predicate device | Meets all defined performance claims. |
| Support intended use | Does not alter the intended use. |
| Not introduce new technological characteristics | Has the same technological characteristics as the legally marketed device. |
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 does not specify the sample size for the test set used in verification and validation activities, nor does it provide details on the data provenance (country of origin, retrospective/prospective). This level of detail is typically found in the full test reports, not a 510(k) summary for modifications.
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)
The document does not specify the number or qualifications of experts used to establish ground truth for the test set.
4. Adjudication method (e.g. 2+1, 3+1, none) for the test set
The document does not specify the adjudication method used for the test set.
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
The document does not mention a multi-reader multi-case (MRMC) comparative effectiveness study. The focus is on software modifications to existing Q-Apps for improved workflow and semi-automation, not necessarily on a comparative effectiveness study of human readers with vs. without AI assistance. The modifications, particularly for MVN and a2DQ, aim to improve user efficiency and ease of use, which would imply an improvement in human reader efficiency but this is not quantified as an effect size from an MRMC study in this summary.
6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done
The document repeatedly mentions "semi-automated border detection" (a2DQ), "automatically draw a region of interest" (aCMQ), and "semi-automation for greater efficiency and ease of use" (MVN), with an explicit mention that "The modified Heart Model application allows users to override border placement. The user may edit the border by clicking and dragging the border to the desired location." This strongly suggests that these are human-in-the-loop applications where the software provides automated assistance but the user retains control and the ability to edit. Therefore, a purely standalone (algorithm-only) performance evaluation independent of human interaction is not implied or described by the context of these modifications.
7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)
The document refers to "Verification and Validation testing" demonstrating that the modified software meets "all defined reliability requirements and performance claims" relative to the "predicate." It does not explicitly state the type of ground truth used. For quantification software in medical imaging, ground truth often involves:
- Manual tracings/measurements by expert cardiologists.
- Correlation with other imaging modalities (e.g., Cardiac MR for Heart Model as mentioned, "Measurements are closely correlated to cardiac MR").
- Possibly phantoms or simulated data for certain aspects.
However, the specific methods are not detailed in this summary.
8. The sample size for the training set
The document does not provide any information regarding the sample size for a training set. As this is a special 510(k) for modifications, it's possible that the modifications primarily involved refinement of existing algorithms and workflows, rather than a complete retraining of an AI model requiring a new, distinct training set.
9. How the ground truth for the training set was established
The document does not provide information on how ground truth for any potential training set was established.
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Special 510(k) Premarket Notification
QLAB Quantification Modifications
510(k) Summary
This summary of safety and effectiveness is provided as part of the Premarket Notification in compliance with 21 CFR. Part 807.92.
1 ) Submitter's name, address, telephone number, contact person
Philips Ultrasound, Inc. 3000 Minuteman Road Andover, MA 01810-6302 Penny Greco, Regulatory Affairs Specialist Tel: (978) 659-4615 Fax (978) 975-7324 E-mail: penny.greco@philips.com
AUG
09 2013
Date prepared: June 12, 2013
- Name of the device, including the trade or proprietary name if applicable, the common or usual name, and the classification name, if known:
Common/Usual Name: Picture Archiving and Communications Systems Workstation
QLAB Quantification Software Proprietary Name: Classification Name: CFR 892.2050, system, image processing, radiological, 90 LLZ, Class II
3) Substantially Equivalent Devices
Philips Ultrasound believes that the modified QLAB a2DQ, aCMQ, MVN, and Heart Model Q-Apps are substantially equivalent to the previously cleared iU22 with 2DO (K042540), QLAB with MVQ (K070792), QLAB CMQ (K120525), and QLAB Heart Model (130159).
4) Device Description
QLAB Quantification software is available either as a stand-alone product that can function on a standard PC, on board a dedicated workstation, or on-board Philips' ultrasound systems. It can be used by trained healthcare professionals for the on-line and off-line review and quantification of ultrasound studies in healthcare facilities/hospitals.
The QLAB Quantification software application package is designed to view and quantify image data acquired on Philips ultrasound products. The four modified plug-ins, a2DO, aCMQ , MVN, and Heart Model are applications within Philips QLAB Quantification software.
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Automated 2D Quantification (a2DQ)
The 2DQ O-App for the display of 2D ultrasound images was originally submitted with Philips iU22 Ultrasound system (K042540). 2DQ has been renamed a2DQ. It computes areas, volumes and advanced parameters for LV systolic and diastolic function including: LV Ejection Fraction (EF), Peak Ejection Rate (PER), Peak Rapid Filling Rate (PRFR) and Atrial Filling Fraction (AFF). It also computes End Systolic Volume (ESV) and End Diastolic Volume (EDV). The Color Kinesis (CK) tool provides color-coded visualization of global and regional wall motion. a2DQ has been modified to improve workflows including semi-automated border detection for cardiac chambers and vessel cavities.
Automated Cardiac Motion Quantification (aCMQ)
CMQ modifications were last addressed in QLAB 510(k) K120525. CMQ has been renamed aCMQ aCMQ provides an angle-independent analysis of regional myocardialtissue velocity, displacement, strain, and strain rate, using the speckle-tracking technology. It generates measurements of the global and regional functions and reports them in a table, a 17-segment bull's eye, and a variety of waveform displays. It additionally computes LV Ejection Fraction (EF), End Systolic Volume (ESV) and End Diastolic Volume (EDV). aCMQ has been modified to automatically draw a region of interest based on the selected anatomical view, (user can edit the ROI if desired).
Mitral Valve Navigator (MVN)
The MVQ plug-in was submitted in QLAB 510(k) K070792. The application, renamed Mitral Valve Navigator (MVN), was originally designed as a manual segmentation interface that would allow for detailed segmentation of the mitral valve annulus, leaflets, and papillary muscle. However, as segmentation using the interface is entirely manual, the approximate time to complete the segmentation ranges from 5-15 minutes, depending on the user's familiarity with the interface, the quality of the image, and the user's knowledge of the mitral valve and experience in interpreting 3D echo images. The modification to MVN (MVQ) updates the application with improved task guidance and semi-automation for greater efficiency and ease of use. The modification focused primarily on decreasing the required workflow time by identifying bottlenecks in the workflow.
Heart Model Quantification (HM)
The Heart Model O-App (K130159) provides one-click visualization of all four cardiac chambers, and quantifies the left ventricle (LV) and left atrium (LA) using a 3D Volume image from an apical four-chamber view. It provides the LV and LA volume, stroke volume, and LV ejection fraction (EF) at end-systole and end-diastole (ED) for adult hearts. It easily delivers the routine 2D views from the 3D volume. Measurements are closely correlated to cardiac MR and are exported to the report. The modified Heart Model application allows users to override border placement. The user may edit the border by clicking and dragging the border to the desired location. Numeric quantification will be updated based upon user placement of borders.
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Special 510(k) Premarket Notification
QLAB Quantification Modifications
The OLAB modifications described in this Special 510(k) submission do not alter the intended use of the QLAB Quantification software with the modified a2DQ, aCMQ, MVN, and Heart Model Q-Apps.
5) Indications for Use
QLAB Quantification software is a software application package. It is designed to view and quantify image data acquired on Philips Healthcare ultrasound products.
6) Technological characteristics
The QLAB Quantification software with the modified Q-Apps has the same technological characteristics as the legally marketed device.
7) Non-clinical performance data
No performance standards for PACS systems or components have been issued under the authority of Section 514. The a2DQ, aCMQ, MVN, and Heart Model modifications were tested in accordance with Philips verification and validation processes. Verification and validation data support the modified QLAB software for the a2DQ, aCMQ, MVN, and Heart Model software relative to the unmodified QLAB software.
Design Control activities to assure the safe and effective performance of the modified plug-ins included, but were not limited to:
- Requirements Review .
- Design Review .
- Risk Management .
- Verification and Validation Testing .
Verification and Validation testing concluded that the modified QLAB O-Apps are safe and effective and introduced no new risks.
8) General Safety and Effectiveness Concerns
The device labeling contains operating instructions for the safe and effective use of the QLAB Quantification software with the modified Q-Apps.
9) Conclusions
Verification and Validation activities required to establish the performance, functionality, and reliability characteristics of the modified QLAB Q-Apps with respect to the predicate were performed. Testing involved system level tests, performance tests, and safety testing from hazard analysis. Testing performed demonstrated that the QLAB Quantification software with modified Q-Apps meets all defined reliability requirements and performance claims.
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Image /page/3/Picture/12 description: The image shows a partial view of a logo. The logo includes the words "HEALTH & HUMAN SERVICES USA" arranged in a circular pattern. To the right of the text is a stylized graphic consisting of three curved lines.
Public Health Service
Food and Onig Administration 10903 New Hampshire Avenue Document Comrol Center - WO66-G609 Silver Spring, MD 20993-002
August 9, 2013
Philips Ultrasound, Inc. % Mr. Mark Job Responsible Third Party Official 1394 25" Street NW BUFFALO MN 55313
Re: K132165
Trade/Device Name: QLAB Quantification Software Regulation Number: 21 CFR 892.2050 Regulation Name: Picture archiving and communications system Regulatory Class: Class II Product Code: LLZ Dated: July 10, 2013 Received: July 12. 2013
Dear Mr. Job:
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 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 (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set
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Page 2 - Mr. Job
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.
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" (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/MedicalDevices/ResourcesforYou/Industry/default.htm.
Sincerely yours,
Sm.h.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
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Indications for Use
510(k) Number (if known): K132165
QLAB Quantification Software Device Name:
Indications for Use:
QLAB Quantification Software is a software application package. It is designed to view QCAD Quantify image data acquired on Philips Healthcare ultrasound products.
Prescription Use X (Part 2) 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)
(Division Sign Off) Division of Radiological Health Office of In Vitro Diagnostic and Rediological Health
510(k)_K132165
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§ 892.2050 Medical image management and processing system.
(a)
Identification. A medical image management and processing system is a device that provides one or more capabilities relating to the review and digital processing of medical images for the purposes of interpretation by a trained practitioner of disease detection, diagnosis, or patient management. The software components may provide advanced or complex image processing functions for image manipulation, enhancement, or quantification that are intended for use in the interpretation and analysis of medical images. Advanced image manipulation functions may include image segmentation, multimodality image registration, or 3D visualization. Complex quantitative functions may include semi-automated measurements or time-series measurements.(b)
Classification. Class II (special controls; voluntary standards—Digital Imaging and Communications in Medicine (DICOM) Std., Joint Photographic Experts Group (JPEG) Std., Society of Motion Picture and Television Engineers (SMPTE) Test Pattern).