K Number
K151212
Device Name
Ziostation2
Manufacturer
Date Cleared
2015-11-04

(182 days)

Product Code
Regulation Number
892.2050
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Ziostation2 is an image processing application software available for installation onto customer owned hardware. This application software can be networked to provide for sharing of resources. This application software receives medical images from modalities (mage scanning devices such as CT) or image archives such as PACS through network or media and provides for the viewing, quantification, manipulation, communication, printing, and management of medical images. This application software is intended for use by trained medical professionals to supplement generally accepted methods of interpreting radiological images. Lossy compressed mammographic images and digitized film screen images must not be reviewed for primary image interpretations. Mammographic images may only be interpreted using a monitor whose characteristics are approved by the regulatory agency governing the market within which Ziostation2 is being offered. Note: The clinician retains the ultimate responsibility for making the proper diagnosis based on standard radiological practices and visual comparison of the separate, unprocessed images. Ziostation2 is a tool to be used in support of those standard practices and visual comparisons.
Device Description
ZIOSTATION2 is a basic DICOM image management system to further aid clinicians in their analysis of anatomy, physiology and pathology. Universal functions such as data retrieval, storage, management, querying and listing, and output are handled by the basic Ziostation2 software. Various imaging tools and techniques can be invoked to process images from the following image types: CT, MRI, Ultrasound, Digital X-ray X-ray Angiography, PET, SPECT, NM, SC, Mammography, X-ray Radiofluoroscopic image, RT Image.
More Information

Not Found

No
The summary describes standard image processing and management functions without mentioning AI, ML, or related concepts.

No.
The device is an image processing and management software intended for use by trained medical professionals to interpret radiological images, not to provide direct therapeutic intervention.

Yes
The software receives, processes, and displays medical images from various modalities, "intended for use by trained medical professionals to supplement generally accepted methods of interpreting radiological images." It aids clinicians in their "analysis of anatomy, physiology and pathology," which are diagnostic activities.

Yes

The device description explicitly states "Ziostation2 is an image processing application software available for installation onto customer owned hardware." This indicates it is a software product designed to run on existing hardware, not a hardware device itself.

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.
  • Device Function: The description clearly states that Ziostation2 is an image processing application software that receives and processes medical images from imaging modalities (like CT, MRI, etc.). It is used for viewing, quantification, manipulation, and management of these images.
  • Intended Use: The intended use is for trained medical professionals to supplement generally accepted methods of interpreting radiological images. This involves analyzing images of the body, not performing tests on samples taken from the body.

The device is a medical image processing and management system, which falls under the category of medical devices, but specifically not in vitro diagnostics.

N/A

Intended Use / Indications for Use

Ziostation2 is an image processing application software available for installation onto customer owned hardware. This application software can be networked to provide for sharing of resources.
This application software receives medical images from modalities (mage scanning devices such as CT) or image archives such as PACS through network or media and provides for the viewing, quantification, manipulation, communication, printing, and management of medical images.
This application software is intended for use by trained medical professionals to supplement generally accepted methods of interpreting radiological images.
Lossy compressed mammographic images and digitized film screen images must not be reviewed for primary image interpretations. Mammographic images may only be interpreted using a monitor whose characteristics are approved by the regulatory agency governing the market within which Ziostation2 is being offered.

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

LLZ

Device Description

ZIOSTATION2 is a basic DICOM image management system to further aid clinicians in their analysis of anatomy, physiology and pathology. Universal functions such as data retrieval, storage, management, querying and listing, and output are handled by the basic Ziostation2 software. Various imaging tools and techniques can be invoked to process images from the following image types: CT, MRI, Ultrasound, Digital X-ray X-ray Angiography, PET, SPECT, NM, SC, Mammography, X-ray Radiofluoroscopic image, RT Image.

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

CT, MRI, Ultrasound, Digital X-ray X-ray Angiography, PET, SPECT, NM, SC, Mammography, X-ray Radiofluoroscopic image, RT Image.

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

trained medical professionals

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 ZIOSTATION2 software package successfully completed integration testing/verification testing prior to Beta validation. Regression testing was also performed on all functionality present on Ziostation. Software Beta testing/validation was successfully completed prior to final testing and release. In addition, potential hazards have been addressed by the Qi Imaging Risk Management process.

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.

K070205, K083446, K073138, K111336, K063324, K052839, K112531, K092013, K110834, K110186, K121676, K110151, K130960, K031261, K122578

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

§ 892.2050 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).

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Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized image of three human profiles facing right, with flowing lines beneath them.

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

November 4, 2015

Qi Imaging, LLC % Mr. Richard Ball Director, Regulatory & Quality Affairs 1301 Shoreway Road. Suite 325 BELMONT CA 94002

Re: K151212 Trade/Device Name: Ziostation2 Regulation Number: 21 CFR 892.2050 Regulation Name: Picture archiving and communications system Regulatory Class: II Product Code: LLZ Dated: October 8, 2015 Received: October 14, 2015

Dear Mr. Ball:

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.

1

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

http://www.fda.gov/MedicalDevices/Resourcesfor You/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 Industry and Consumer Education 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,

Robert Ochs

Robert Ochs, Ph.D. 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) K151212

Device Name Ziostation2

Indications for Use (Describe)

Ziostation2 is an image processing application software available for installation onto customer owned hardware. This application software can be networked to provide for sharing of resources.

This application software receives medical images from modalities (mage scanning devices such as CT) or image archives such as PACS through network or media and provides for the viewing, quantification, manipulation, communication, printing, and management of medical images.

This application software is intended for use by trained medical professionals to supplement generally accepted methods of interpreting radiological images.

Lossy compressed mammographic images and digitized film screen images must not be reviewed for primary image interpretations. Mammographic images may only be interpreted using a monitor whose characteristics are approved by the regulatory agency governing the market within which Ziostation2 is being offered.

Type of Use (Select one or both, as applicable)
☑ Prescription Use (Part 21 CFR 801 Subpart D)☐ Over-The-Counter Use (21 CFR 801 Subpart C)

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DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

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510(k) Summary Ziostation2 Qi Imaging, LLC

This 510(k) summary is prepared in accordance with 21 CFR 807.92.

General Information

Trade NameZiostation2
Common Name
Classification NamePicture Archiving and Communications System (PACS)
System, Image Processing, Radiological (21 CFR § 892.2050 - LLZ)
Applicant:Qi Imaging, LLC
1301 Shoreway Road, Suite 325
Belmont, CA 94002
Tel 650-413-1364
Fax 650-596-7319
ContactRichard Ball
Sr. Director, Regulatory and Quality Affairs

Intended Use

  • . Ziostation (hereinafter "this application software") is an image processing application software available for installation onto customer-owned hardware. This application software can be networked to provide for sharing of resources.
  • This application software receives medical images from modalities (medical image scanning devices such as CT) or image archives such as PACS through network or media and provides for the viewing, quantification, manipulation, communication, printing, and management of medical images.
  • . This application software is intended for use by trained medical professionals to supplement generally accepted methods of interpreting radiological images.
  • . Lossy compressed mammographic images and digitized film screen images must not be reviewed for primary image interpretations. Mammographic images may only be interpreted using a monitor whose characteristics are approved by the regulatory agency governing the market within which Ziostation2 is being offered.

Note: The clinician retains the ultimate responsibility for making the proper diagnosis based on standard radiological practices and visual comparison of the separate, unprocessed images. Ziostation2 is a tool to be used in support of those standard practices and visual comparisons.

4

Predicate Devices

Predicate devices to Ziostation2 Software Tool

| Device Name | 510(k)
Number |
|---------------------------------------------------------------------------|------------------|
| Ziostation
(Multiple Protocol Enhancements) | K070205 |
| Ziostation with
Cardiac Function Analysis and Calcium Scoring Software | K083446 |
| CARDIQ Express v2.0 | K073138 |
| EBW NM 2.0 | K111336 |
| PET VCAR | K063324 |
| CT Perfusion 4 | K052839 |
| Vitrea CT Myocardial Analysis | K112531 |
| Syngo Volume Perfusion, CT Body | K092013 |
| AW Volume Share 5 | K110834 |
| Synapse 3D Liver Analysis | K110186 |
| Signa HDxT HD | K121676 |
| Achieva R2 1.5T/3.0T | K110151 |
| SureSubtraction Ortho CSSO-001A | K130960 |
| CardEP | K031261 |
| Vitrea CT Transcatheter Aortic Valve Replacement Planning | K122578 |

Device Description

ZIOSTATION2 is a basic DICOM image management system to further aid clinicians in their analysis of anatomy, physiology and pathology. Universal functions such as data retrieval, storage, management, querying and listing, and output are handled by the basic Ziostation2 software. Various imaging tools and techniques can be invoked to process images from the following image types: CT, MRI, Ultrasound, Digital X-ray X-ray Angiography, PET, SPECT, NM, SC, Mammography, X-ray Radiofluoroscopic image, RT Image.

New Features – Substantial Equivalence Discussion

Image Viewing/Tool Enhancements – Ref. Ziostation K070205 and Ziostation w/ Cardiac Function
Analysis K083446 as predicate devices
CapabilitySubstantial Equivalence
Fusion ViewerK070205 Fusion Viewer is a workflow enhancement and is substantially equivalent to the current Ziostation ability to fuse images.
PhyZiodynamicsK070205 PhyZiodynamics reconstructs data with the addition of noise reduction and motion coherence to improve image quality and is substantially equivalent to the current Ziostation data reconstruction capability.

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| CT Coronary
Analysis | K070205 (Secondary K073138) Improvements to CT Coronary include
automatic vessel labeling and color coding of HU ranges of specified areas
for easier visualization of suspected areas of interest. This tool with its
expanded capabilities is substantially equivalent to the current Ziostation
coronary analysis tool. |
|----------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| CT Colon Analysis | K070205 (Secondary K110834) The added capability to automatically
measure and report on user-specified ROI's is a workflow enhancement.
This capability is substantially equivalent to the current Ziostation CT
Colon tool. |
| CT/SPECT Cardiac
Fusion | K070205 (Secondary K111336) The functionality being added to the
already cleared CT/SPECT Cardiac Fusion ability of the current Ziostation
device is to provide data and polar maps of stress, rest, reversibility and
washout. This workflow enhancement is substantially equivalent to the
current Ziostation CT/SPECT Cardiac Fusion tool. |
| SUV Measurement | K070205 (Secondary K063324) Uses current multi-exam comparison
capability of PET images to visualize and monitor disease progression or
response to treatment or therapy. This workflow enhancement is
substantially equivalent to the current Ziostation PET imaging tool. |
| CT Subtraction | K070205 (Secondary K130960) CT Subtraction improves the current
capability of contrast enhancement visualization. This improvement is
substantially equivalent to the current Ziostation contrast enhancement
capability. |
| EP Planning | K070205 (Secondary K031261) Using currently available display and
measurement tools, EP Planning allows the physician to concentrate on
certain specific areas of the heart. This tool is substantially equivalent to
the current Ziostation display and measurement capability. |
| TAVR | K070205 (Secondary K122578) Using currently available display and
measurement tools, TAVR allows the physician to concentrate on certain
specific areas of the heart, including aortic valve and surrounding
structures. This tool is substantially equivalent to the current Ziostation
display and measurement capability. |
| CT Cardiac RV | K083446 (Secondary K110834) Using currently available display and
measurement tools, CT Cardiac RV adds the capability to calculate and
display various functional parameters of the right ventricle. This added
capability is substantially equivalent to the current Ziostation capability to
provide functional ventricular information. |

Additional Image Processing Functionalities

CT Perfusion Analysis
CT Perfusion
AnalysisK052839 Both the Qi Imaging feature and the GE predicate feature are
image analysis software applications that allow evaluation of dynamic CT
data following the injection of a compact bolus of contrast material,
generating information with regard to changes in image intensity over
time. Both features allow assessment of the type and extent of various
perfusion related parameters. The Qi Imaging CT Perfusion feature is
substantially equivalent to GE CT Perfusion 4.
CT Volume
PerfusionK052839 Both the Qi Imaging feature and the GE predicate feature are
image analysis software applications that allow evaluation of dynamic CT
data following the injection of a compact bolus of contrast material,
generating information with regard to changes in image intensity over

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| | time. Both features allow assessment of the type and extent of various
perfusion related parameters in user-specified planes of orientation. The Qi
Imaging CT Volume Perfusion feature is substantially equivalent to GE
CT Perfusion 4. |
|------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| CT Myocardial
Perfusion | K112531 Both the Qi Imaging feature and the Vital Images feature
provide color-coded polar maps of the contrasted myocardium based on
the calculation of transmural perfusion ratios. The Qi Imaging CT
Myocardial Perfusion feature is substantially equivalent to Vital Images
Vitrea CT Myocardial Analysis |
| CT Dynamic
Myocardial Perfusion | K092013 Both the Qi Imaging feature and the Siemens feature provide 3-
dimensional calculation of Blood Flow, Blood Volume and other
functional parameters by displaying color coded maps of individual
parameters on user-specified regions of the myocardium. The Qi Imaging
CT Dynamic Myocardial Perfusion feature is substantially equivalent to
Siemens syngo Volume Perfusion – CT Body |
| CT Lesion Analysis | K110834 Both the Qi Imaging feature and the GE feature allow extraction
and measurement of lesions, enabling observation of changes over time.
The Qi Imaging CT Lesion Analysis feature is substantially equivalent to
GE AW Volume Share 5 |
| CT Liver Analysis | K110186 Both the Qi Imaging CT Liver feature and the Fuji Film feature
allow auto-segmentation/calculation of liver features such as liver
structure, volumes, tumors and manual definition of separation plane
proposals. The Qi Imaging CT Liver Analysis feature is substantially
equivalent to Fuji Film Synapse 3D Liver Analysis |
| MR Tractography | K121676 and K110151 Qi Imaging MR Tractography feature, the GE
device and the Philips device all present DTI Tractography data showing
colored tracts of various anatomical fibers of interest overlaid onto the
surrounding anatomy. The Qi Imaging MR Tractography feature is
substantially equivalent to the comparable software features of both GE
Signa HDXT and Philips Achieva R41.5T & 3.0T. |

Materials

This software tool consists entirely of software. No materials are contained in this product.

Testing Summary

The ZIOSTATION2 software package successfully completed integration testing/verification testing prior to Beta validation. Regression testing was also performed on all functionality present on Ziostation. Software Beta testing/validation was successfully completed prior to final testing and release. In addition, potential hazards have been addressed by the Qi Imaging Risk Management process.

Summary of Substantial Equivalence

ZIOSTATION2 is substantially equivalent in intended use and function to the composite of predicate devices identified above.