K Number
K132963
Device Name
FUSIONSYNC, CHIMAERA FUSIONSYNC
Manufacturer
Date Cleared
2013-12-16

(87 days)

Product Code
Regulation Number
892.2050
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The device FusionSync contains automatic registration algorithms that are intended for the spatial synchronization of different series. The automatic algorithm is not intended for the registration of series from modalities other than: CT, conventional MRI, PET or SPECT. In addition, the product contains a manual mode (non-automatic) that allows the registration via user interaction such that for example automatic registration results can be refined. The intended clinical use is to display different 3D series from the same patient in spatial synchronization as for example, but not limited to, followup examinations. The displayed series can be visualized as MPR views with arbitrary 3D orientation. It is possible to overlay a registered series onto an MPR view. The spatial synchronization and optional overlay, based on the registration result, is intended to help the clinician to obtain a better understanding of the joint information of two registered images. The clinician retains the responsibility for making the diagnosis based on their standard procedures where the separate unregistered images are compared visually. FusionSync complements these clinical standard procedures.
Device Description
FusionSync is a software program that provides a registration engine to align (register) pairs of images from same and different imaging modalities. The platform-independent registration engine is designed as a plug-in component that has the ability to extend the productivity of existing viewers like CAD workstations or PACS. The graphical user interface of FusionSync is designed as a plug-in component for avean workstation OsiriX PRO. It includes functionality to display the original volumetric data and the results of the registration operation. The graphical user interface allows to control the registration engine and fusion visualization.
More Information

Not Found

Unknown
The summary mentions "automatic registration algorithms" but does not explicitly state whether these algorithms utilize AI or ML techniques. The "Mentions AI, DNN, or ML" section is marked as "Not Found," and there is no description of training or test sets, which are common for ML-based devices. However, some automatic registration algorithms can be implemented using ML, so it's not possible to definitively say based on this summary alone.

No.
The device's intended use is to spatially synchronize different series to help clinicians better understand joint information from registered images, not to treat or diagnose. It complements standard procedures and does not claim to directly affect patient health outcomes.

No.

The device FusionSync is intended to help clinicians obtain a better understanding of the joint information of two registered images by spatially synchronizing them and allowing optional overlay. It states that "The clinician retains the responsibility for making the diagnosis based on their standard procedures where the separate unregistered images are compared visually. FusionSync complements these clinical standard procedures." This indicates that FusionSync is a tool to assist in visualization and comparison, not to make a diagnosis itself.

Yes

The device description explicitly states that FusionSync is a "software program" and a "platform-independent registration engine designed as a plug-in component." It also mentions the graphical user interface is designed as a "plug-in component." There is no mention of accompanying hardware.

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. They are used to provide information for diagnosis, monitoring, or screening.
  • FusionSync's Function: FusionSync is a software program that processes and displays medical images (CT, MRI, PET, SPECT) acquired from the patient's body. It performs image registration and visualization to aid clinicians in interpreting these images.
  • Lack of Biological Sample Analysis: The device does not analyze any biological samples from the patient. Its input is image data, not biological specimens.
  • Intended Use: The intended use is to help clinicians understand the joint information of registered images for diagnostic purposes, but it does not perform a diagnostic test on a biological sample itself. The clinician retains responsibility for the diagnosis based on their standard procedures.
  • Regulatory Classification: The device is classified as a Class II Picture Archiving and Communications System (892.2050) with Product Code LLZ (Image Processing System). This classification is consistent with medical image processing software, not IVDs.

In summary, FusionSync is a medical image processing and visualization tool, not a device that performs diagnostic tests on biological samples. Therefore, it does not fit the definition of an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

The device FusionSync contains automatic registration algorithms that are intended for the spatial synchronization of different series. The automatic algorithm is not intended for the registration of series from modalities other than: CT, conventional MRI, PET or SPECT. In addition, the product contains a manual mode (non-automatic) that allows the registration via user interaction such that for example automatic registration results can be refined. The intended clinical use is to display different 3D series from the same patient in spatial synchronization as for example, but not limited to, followup examinations. The displayed series can be visualized as MPR views with arbitrary 3D orientation. It is possible to overlay a registered series onto an MPR view. The spatial synchronization and optional overlay, based on the registration result, is intended to help the clinician to obtain a better understanding of the joint information of two registered images. The clinician retains the responsibility for making the diagnosis based on their standard procedures where the separate unregistered images are compared visually. FusionSync complements these clinical standard procedures.

Product codes

LLZ

Device Description

FusionSync is a software program that provides a registration engine to align (register) pairs of images from same and different imaging modalities. The platform-independent registration engine is designed as a plug-in component that has the ability to extend the productivity of existing viewers like CAD workstations or PACS. The graphical user interface of FusionSync is designed as a plug-in component for avean workstation OsiriX PRO. It includes functionality to display the original volumetric data and the results of the registration operation. The graphical user interface allows to control the registration engine and fusion visualization.

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

MRI, CT, SPECT, PET

Anatomical Site

Not Found

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)

Performance testing included software validation, verification and testing per FDA's software validation guidance.

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

Not Found

Predicate Device(s)

K020546

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 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).

0

K132963
Page 1 of 6

FusionSync

510(k) SUMMARY

DEC 1 6 2013 AERA

510(k) summary of safety and effectiveness (21 CFR 807.92):

| Date of summary:

807.92(a)(1)08/08/2013
Owner/Submitter's name:
807.92(a)(1)Chimaera GmbH
Owner/Submitter's address:
807.92(a)(1)Am Weichselgarten 7,
91058 Erlangen, Germany
Owner/Submitter's contact:
807.92(a)(1)Marcus Pruemmer
Telephone number:
807.92(a)(1)+49 9131 691385
Fax number:
807.92(a)(1)+49 9131 691386
Device Proprietary Names:
807.92(a)(2)FusionSync 1.0
Chimaera FusionSync 1.0
Device Common Name(s):
807.92(a)(2)Multi-modality Registration Software
Classification Name:
807.92(a)(2)Class II: Picture Archiving and Communications System
(892.2050) Product Code: LLZ Image Processing System

807.92(u)(3):

FusionSync is Substantially Equivalent to the following Legally Marketed device:

510(k) NumberTrade NameManufacturer
K020546Fusion 7DMirada Medical Ltd.

Definitions:

Image Registration
The alignment of one or more images to a reference image. The alignment is computed based on a mathematical optimization problem that spatially correlates the images according functional activity or anatomical structures. The result of a registration is a transform that describes the spatial

Chimaera GmbH

1

510(k) SUMMARY FusionSync

Traditional Premarket Notification 510(k)

correlation of 3D positions between the images.
Image FusionVisualize the content of different images (usually the same organ or
anatomical region) in the same image viewer window. A common technique
is to overlay the different images via semi-transparent rendering.
Synchronization/
BindingSpatial linking of two different image views (no overlay), as for example
Multiplanar Reconstruction (MPR) views. The registration transform builds
the spatial link between two series such that the visualization setting (e.g.
spatial orientation and position) of one MPR view is transferred to a linked
MPR view such that both views show the same anatomical region during
navigation of one of the MPRs through the volumetric data.

1 DEVICE DESCRIPTION (807.92(a)(4))

Labeling Description Example:

Today, diagnosis based on follow-up image series and multi-modal acquisitions is often timeconsuming due to missing data alignment and the need for manual adaptions of viewing settings. FusionSync is a fast, automatic image-registration algorithm that is scamlessly integrated in the aycan workstation OsiriX PRO. FusionSync allows viewing of multi-modal and follow-up series together. Users can navigate easily through large data sets based on spatial synchronization. Timeconsuming adaptions of view settings are completely eliminated, as viewing properties are propagated to all linked series.

Device Description:

FusionSync is a software program that provides a registration engine to align (register) pairs of images from same and different imaging modalities. The platform-independent registration engine is designed as a plug-in component that has the ability to extend the productivity of existing viewers like CAD workstations or PACS. The graphical user interface of FusionSync is designed as a plug-in component for avean workstation OsiriX PRO. It includes functionality to display the original volumetric data and the results of the registration operation. The graphical user interface allows to control the registration engine and fusion visualization.

Registration Engine:

FusionSync supports the registration of anatomical images (MRI and CT) and functional images (SPECT and PET). The registration engine provides a) manual registration, where the user defines the registration transform and b) automatic registration, where the software computes without any user input the registration result. The transformation is limited to a rigid body deformation (i.e. translation and rotation). The registration engine allows to register any combination of CT, conventional MRI, PET and SPECT images. The advanced technology of our registration engine is designed to easily and rapidly integrate into existing medical imaging applications.

2 INTENDED USE (807.92(a)(5))

The device FusionSyne contains automatic registration algorithms that are intended for the spatial

2

FusionSync

synchronization of different series. The automatic algorithm is not intended for the registration of series from modalities other than: CT, conventional MRI, PET or SPECT. In addition, the product contains a manual mode (non-automatic) that allows the registration via user interaction such that for example automatic registration results can be refined. The intended clinical use is to display different 3D series from the same patient in spatial synchronization as for example, but not limited to, followup examinations. The displayed series can be visualized as MPR views with arbitrary 3D orientation. It is possible to overlay a registered series onto an MPR view. The spatial synchronization and optional overlay, based on the registration result, is intended to help the clinician to obtain a better understanding of the joint information of two registered images. The clinician retains the responsibility for making the diagnosis based on their standard procedures where the separate unregistered images are compared visually. FusionSync complements these clinical standard procedures.

3 TECHNOLOGICAL CHARACTERISTICS/FEATURE COMPARISON

807.92(a)(6):

The following Table 1 provides technological characteristics and a feature comparison to the predicate device:

FeatureFusion7DFusionSync
Registration Engine
Automatic RegistrationYESYES
Manual RegistrationYESYES
Semi-automatic
(matching of landmarks)YES. NO
Rigid body deformation
i.e. translation and rotationYESYES
Consecutive sequence of
fusion methods.
(An automatic fusion can be run on the
results of an initial step e.g. manual
registration)YESYES
Fast Registration20-30s even for very large
imaging studies.3-10s even for very large
imaging studies.
Spatial Precision
  1. Precision depends on the accuracy of
    the lowest resolution voxel in either the
    source or target imaging study.
  2. For high resolution CT or MRI the
    fusion should achieve millimeter-level
    accuracy
  3. Lower resolution data sets for
    functional imaging typically have a voxel
    resolution of several millimeters (even
    centimeters in the slicing direction) | | YES | YES |
    | Deformable body deformation
    i.e. non-rigid registration | | YES (Fusion7D Advanced)
    NO (Fusion7D Standard) | NO |
    | Supported data to compare
    pairs of images: | | | |
    | Anatomical to Anatomical | | | |
    | Source | Target | | |
    | MRI | MRI | YES | YES |
    | MRI | CT | YES | YES |
    | CT | CT | YES | YES |
    | Anatomical to Functional | | | |
    | Source | Target | | |
    | MRI | PET | YES | YES |
    | MRI | SPECT | YES | YES |
    | CT | PET | YES | YES |
    | CT | SPECT | YES | YES |
    | Data/Image Browsing and Visualization | | | |
    | Orthogonal and any-plane
    slicing of the volumetric data | | YES | YES |
    | Whole and region of interest
    zooming | | YES | YES |
    | Panning | | YES | YES |
    | Window and level controls | | YES | YES |
    | Image overlays for which the
    transparency, threshold and
    colormap is user controlled | | YES | YES |
    | Bindings/Spatial
    Synchronization
    (using tools such as Zoom affect every
    image window) | YES | YES | |
    | Save/Load Transformation
    (registration matrix) | YES | NO | |
    | Live Updates
    (shows on the screen the steps in the
    registration process) | YES | NO | |
    | Stand-Alone Workstation
    Software | YES | NO | |
    | Application Range | Radiology, Nuclear Medicine | Radiology, Nuclear Medicine | |
    | Supports compressed image
    formats | NO | NO | |
    | Snapshot (capture any image) | YES | YES | |

3

510(k) SUMMARY

FusionSync

______________________________________________________________________________________________________________________________________________________________________________

.

4

510(k) SUMMARY Traditional Premarket Notification 510(k)

Tuble 2: Comparison of technological features

3.a SUMMARY

FusionSync

FusionSync does not provide landmark based registration. However, this feature requires the user to manually place software based landmarks in the rendered images. This is very time consuming and usually a feature that is rarely used in standard clinical routines. It is sufficient to provide a manual registration to allow a physician a refinement/correction of an automatic registration result. Furthermore, FusionSync does not feature a live update of the fused images during the registration process. This does not effect the effectiveness of the device since there is no diagnostic benefit from showing intermediate results of a registration that takes in average less than three seconds.

4 DISCUSSION OF NON-CLINICAL TESTS PERFORMED FOR

DETERMINATION OF SUBSTANTIAL EQUIVALENCE

807.92(b)(1):

Performance testing included software validation, verification and testing per FDA's software validation guidance.

5 DISCUSSION OF CLINICAL TESTS PERFORMED

807.92(b)(2): N/A

6 SUMMARY AND CONCLUSIONS

807.92(b)(3):

The intended use, technological characteristics/features and performance characteristics for FusionSync are substantially equivalent to the legally marketed predicate device Fusion7D. The documentation supplied demonstrates that any difference in technological characteristics do not raise

Chimacra GmbH

5

K132963
Page 6 of 6

510(k) SUMMARY FusionSync

Traditional Premarket Notification 510(k)

any new question of safety or effectiveness.

The 510(k) Pre-Market Notification for FusionSync contains adequate information and data to enable FDA – CDRH to determine substantial equivalence to the predicate device. The submission contains the results of a hazard analysis and the "Level of Concern" for potential

hazards has been classified as "Moderate".

Chimaera GmbHi

6

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

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

December 16, 2013

Chimaera GmbH % Marcus Pruemmer, Dr .- Ing, CEO Am Weichselgarten 7 Erlangen, Bavaria, 91058 GERMANY

Re: K132963

Trade/Device Name: FusionSync, Chimaera FusionSync Regulation Number: 21 CFR 892.2050 Regulation Name: Picture archiving and communications software Regulatory Class: Class II Product Code: LLZ Dated: September 26, 2013 Received: September 27, 2013

Dear Dr. Pruemmer:

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

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.

7

Page 2-Dr. Pruemmer

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/ResourcestorYou/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/Safetv/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,

for

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

Enclosure

8

.............................................................................................................................................................................. Food and Drug Administration

Indications for Use

510(k) Number (if known) K132963

Device Name

FusionSync

Indications for Use (Describe)

The device FusionSync contains automatic registration algorithms that are intended for the spatial synchronization of different series. The automatic algorithm is not intended for the registration of series from modalities other than: CT, conventional MRI, PET or SPECT. In addition, the product contains a manual mode (non-automatic) that allows the registration via user interaction such that for example automatic registration results can be refined. The intended clinical use is to display different 3D series from the same patial synchronization as for example, but not limited to, followup examinations. The displayed series can be visualized as MPR views with arbitrary 3D orientation. It is possible to overlay a registered series onto an MPR view. The spatial synchronization and optional overlay, based on the registration result, is intended to help the clinician to obtain a better understanding of the joint information of two registered images. The clinician retains the responsibility for making the diagnosis based on their standard procedures where the separate unregistered images are compared visually. FusionSync complements these clinical standard procedures.

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)
Page 1 of 2
PSC Publishing Services (301) 443-6740

FORM FDA 3881 (9/13)

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