Volpara is a software application intended for use with the raw data from digital breast x-ray systems, including tomosynthesis. Volpara calculates and quantifies a density map and from that determines volumetric breast density as a ratio of fibroglandular tissue and total breast volume estimates. Volpara provides these numerical values along with a BI-RADS breast density 4th or 5th Edition category to aid health care professionals in the assessment of breast tissue composition. Volpara is not an interpretive or diagnostic aid and should be used only as adjunctive information when the final assessment of breast density category is made by an MQSA qualified interpreting physician.

Device Description

The Volpara 1.5.2 software provides volumetric assessment of digital x-ray images of the breast, including in that definition both digital mammograms and raw tomosynthesis projections. The assessment takes the form of generating and validating density maps where the value at each pixel represents the thickness of fibroglandular tissue between that pixel and the x-ray source. From those density maps various quantitative densitymap based statistics are computed, namely:

volume of fibroglandular tissue in cm3, ●
volume of breast in cm3 ●
the volumetric breast density in %,
a BI-RADS 4th Edition or 5th Edition breast density category ●
average thickness of dense tissue
maximum thickness of dense tissue
maximum volume of dense tissue above any 1cm² square region ●
The device outputs those numbers along with the density maps themselves marked with the location of the various maxima.
Volpara operates on a Windows server that meets Volpara data input and output requirements and generally is located outside the patient environment. The device does not contact the patient, nor does it control any life-sustaining devices.

AI/ML Overview

Here's a breakdown of the acceptance criteria and the study information based on the provided text for the Volpara Imaging Software:

Note: The provided document is a 510(k) summary for a modification to an existing device (Volpara Imaging Software 1.5.2 building on 1.5.1). Therefore, much of the comprehensive study data might be referenced from the predicate device's clearance (K152028). The current document focuses on verification and validation for the specific modifications.

Acceptance Criteria and Reported Device Performance

The document does not explicitly list a table of quantified acceptance criteria with corresponding device performance metrics in the format requested. Instead, it describes various "Performance Data" and states that "established acceptance criteria was met for all of the tests conducted."

However, we can infer the types of performance criteria based on the verification bench testing:

Acceptance Criteria (Inferred from Test Objective)	Reported Device Performance (Summary from text)
Measurement accuracy (Volpara estimates vs. known values from phantoms)	"Measurement accuracy was assessed by comparing Volpara estimates with known values from breast phantoms." - "All verification and validation testing was successful in that established acceptance criteria was met."
Relationship to ground truth (Volpara estimates vs. 3D breast MRI data for fibroglandular tissue)	"Relationship to ground truth was assessed by running Volpara over x-ray images of breasts for which there was 3D breast MRI data available with a comparison of estimates of fibroglandular tissue." - "All verification and validation testing was successful in that established acceptance criteria was met."
Reproducibility (Volpara results for breast density compared with expected decrease with age)	"Reproducibility was assessed by running Volpara over substantial datasets where we have the women's age and results compared with the expected and known decrease in breast density with age." - "All verification and validation testing was successful in that established acceptance criteria was met."
Reproducibility (Volpara results for left/right breasts and CC/MLO views)	"Reproducibility was assessed by running Volpara over substantial data sets and the results for left and right breasts and CC and MLO views were compared to confirm that the results were similar for each view and each breast." - "All verification and validation testing was successful in that established acceptance criteria was met."
Reproducibility (Volpara results for same woman imaged on GE and Hologic systems one year apart)	"Reproducibility was assessed by running Volpara over substantial data sets where the same woman had been imaged on GE and Hologic systems one year apart and the results were compared to confirm they were similar." - "All verification and validation testing was successful in that established acceptance criteria was met."
Reproducibility (Volpara results for same woman imaged on GE, Hologic, Siemens tomosynthesis-compatible units in both tomosynthesis and mammography modes)	"Reproducibility was assessed by running over substantial data sets where the same woman had been imaged on one of GE, Hologic and Siemens tomosynthesis-compatible units running in both tomosynthesis and mammography modes, and the results were compared to confirm they were similar." - "All verification and validation testing was successful in that established acceptance criteria was met."
Relationship to visual assessment (Volpara BI-RADS category vs. MQSA qualified radiologist assessment)	"Relationship to visual assessment was assessed by running Volpara over x-ray images for which a BI-RADS 4th and 5th Edition density category was available from MQSA qualified radiologists followed by a comparison of the two sets of data." - "All verification and validation testing was successful in that established acceptance criteria was met."
Physician ability to integrate software and assess usability (Beta site testing)	"Beta site testing to assess the ability of physicians to successfully integrate the software into their existing systems as well as assess usability for target users." - "All verification and validation testing was successful in that established acceptance criteria was met."
Comparison of Volpara breast densities to existing databases (Beta site testing)	"Beta site testing to collect minimum, average and maximum Volpara breast densities and compare these to other existing databases." - "All verification and validation testing was successful in that established acceptance criteria was met."

Study Information

Sample size used for the test set and the data provenance:
- Sample Size: Not explicitly stated with a specific number for each test. The text frequently uses the phrase "substantial datasets," indicating a significant but unspecified quantity of images/patients.
- Data Provenance: Not explicitly stated (e.g., country of origin). Some tests involve "x-ray images of breasts" and "existing databases." For the reproducibility tests involving different imaging systems (GE, Hologic, Siemens), it implies multi-vendor data. The "expected and known decrease in breast density with age" suggests real-world patient data.
Number of experts used to establish the ground truth for the test set and the qualifications of those experts:
- Number of Experts: Not explicitly stated how many specifically, but for the "Relationship to visual assessment" ground truth, it states, "BI-RADS 4th and 5th Edition density category was available from MQSA qualified radiologists."
- Qualifications: "MQSA qualified radiologists." (MQSA refers to the Mammography Quality Standards Act, implying specialized training and certification in mammography interpretation).
Adjudication method for the test set:
- Not explicitly stated. For the visual assessment comparison, it mentions a "comparison of the two sets of data" (Volpara vs. radiologists), but details on how discrepancies were resolved or if consensus reading was performed are not provided.
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:
- No MRMC comparative effectiveness study is described in this document. The device is explicitly stated as "not an interpretive or diagnostic aid and should be used only as adjunctive information." Therefore, the study focuses on the device's accuracy and reproducibility in providing density measurements, not on improving human reader performance.
If a standalone (i.e. algorithm only without human-in-the-loop performance) was done:
- Yes, the verification and validation tests described are primarily standalone performance assessments of the Volpara algorithm in calculating density, reproducibility, and correlation with other measurements (MRI, radiologist BI-RADS assessment). The beta site testing involves physicians but to assess usability and integration, not to measure human-in-the-loop diagnostic performance.
The type of ground truth used (expert consensus, pathology, outcomes data, etc):
- Known values from breast phantoms: For measurement accuracy.
- 3D breast MRI data: For fibroglandular tissue volume comparison (considered a more objective measure than visual assessment).
- Expected and known decrease in breast density with age: For reproducibility validation.
- MQSA qualified radiologists' BI-RADS 4th and 5th Edition density categories: For comparison to visual assessment.
- Existing databases: For comparison of Volpara breast densities during beta site testing.
The sample size for the training set:
- The document does not provide information about the training set size or methodology. This is a 510(k) summary for a device modification, and often details about initial model training are not reiterated if they were part of the predicate device's submission.
How the ground truth for the training set was established:
- Not specified in this document.

Summary

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Image /page/0/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo features a stylized eagle with its wings spread, and the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the eagle. The eagle is black, and the text is also black.

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

January 7, 2016

Matakina Technology Ltd. % Ralph Highnam, Ph.D. CEO Level 12, 86 Victoria Street Wellington, 6011 NEW ZEALAND

Re: K153427

Trade/Device Name: Volpara Imaging Software Regulation Number: 21 CFR 892.2050 Regulation Name: Picture archiving and communications system Regulatory Class: II Product Code: LLZ Dated: November 19, 2015 Received: November 25, 2015

Dear Dr. Highnam:

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.

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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/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 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.

Michael D'Hara

For

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) K153427

Device Name Volpara Imaging Software

Indications for Use (Describe)

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)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

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Image /page/3/Picture/0 description: The image shows the logo for Mātākina Technology. The logo features the word "mātākina" in bold, dark green letters above the word "technology" in a smaller, lighter blue font. The words are set against a light blue circular background with a crescent shape cut out of the top left portion.

510(k) Summarv Prepared 13th November 2015

Sponsor:	Matakina Technology Limited
Company Address:	Level 12, 86 Victoria Street, Wellington, 6011, New Zealand
Contact Person:	Ralph Highnam
Telephone:	+64 - 4 - 499 - 6029
Fax:	+64 - 4 - 499 - 6029
Email:	ralph.highnam@volparasolutions.com
Submission Date:	16th November 2015
Device Name:	Volpara Imaging Software
Common Name:	Imaging Software
Classification:Regulatory Class:Review Category:	IIClass II

eyol y Classification Panel: Radiology System, Imaging Processing; 21 CFR 892.2050; LLZ

Legally Marketed Predicate Devices:

The modified software, Volpara Imaging Software ("Volpara") 1.5.2 is substantially equivalent to the Volpara Imaging Software 1.5.1 cleared pursuant to K152028 (Matakina Technology Limited) on October 26th, 2015, which serves as the primary predicate, as well as K102556 cleared on 7th October, 2010.

Predicate Device Description:

Volpara Imaging Software 1.5.1 generated and validated density maps from digital x-ray images of the breast and from those density maps computed various quantitative densitymap based statistics, for example, volume of fibroglandular tissue in cm³, volume of breast in cm³, and their ratio, the volumetric breast density, and then provided a mechanism to generate a Breast Imaging-Reporting and Data System (BI-RADS) breast density category from the volumetric breast density.

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Image /page/4/Picture/0 description: The image shows a document header with the Mātakina Technology logo on the left. The document type is a report, with DMS number mtk1956-007-6 and DMS reference Eng/Angel. The revision date is December 26th, 2015, and it is page 2 of 5. The title of the document is "Volpara Imaging Software 510(k) Summary".

Volpara Imaging Software 1.5.1 operates on a Windows server that meets Volpara data input and output requirements and generally is located outside the patient environment.

Comparison with Predicate Device:

Volpara Imaging Software 1.5.2 works in the same way as Volpara Imaging Software 1.5.1 but also provides the density maps via user selectable viewing options along with additional quantitative statistics computed on the density map.

Substantial Equivalence Comparison Table

	Predicate Device	Submission Device,
	Volpara, 1.5.1 (K152028)	Volpara 1.5.2
Intended Use (difference is underlined)	"Volpara is a software applicationintended for use with the raw datafrom digital breast x-ray systems,including tomosynthesis. Volparacalculates a density map and fromthat determines volumetric breastdensity as a ratio of fibroglandulartissue and total breast volumeestimates. Volpara provides thesenumerical values along with a BI-RADS breast density 4th or 5thEdition category to aid health careprofessionals in the assessment ofbreast tissue composition. Volparaproduces adjunctive information. Itis not an interpretive or diagnosticaid"	"Volpara is a software applicationintended for use with the raw datafrom digital breast x-ray systems,including tomosynthesis. Volparacalculates and quantifies a densitymap and from that determinesvolumetric breast density as a ratioof fibroglandular tissue and totalbreast volume estimates. Volparaprovides these numerical valuesalong with a BI-RADS breastdensity 4th or 5th Edition category toaid health care professionals in theassessment of breast tissuecomposition. Volpara is not aninterpretive or diagnostic aid andshould be used only as adjunctiveinformation when the finalassessment of breast densitycategory is made by an MQSA-qualified interpreting physician."
Intended Users	Health Care Professionals	Health Care Professionals
Image Source	Digital mammography images	Digital mammography images.
Image Sources	Digitalmammograms frommammography or tomosynthesissystems.	Digitalmammograms frommammography or tomosynthesissystems.
Anatomical Area	Breast	Breast
Assessment Scope	Volumetric	Volumetric
Operating Environment	Windows	Windows
Image Storage and Report Generation	YesOutput to the console	YesOutput to the console
Numeric Output	Volume of Fibroglandular tissueVolume of Breast	Volume of Fibroglandular tissueVolume of Breast

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	Volumetric Breast DensityBIRADS 4th or 5th Edition BreastDensity Category	Volumetric Breast DensityBIRADS 4th or 5th Edition BreastDensity Category
		Average thickness of dense tissue
		Maximum thickness of densetissue (and location).
		Maximum volume of dense tissueabove any 1cm² square region(and location).
Image Output	None	Density map in DICOM SCI format,for visualization as user requires.
Classification	21 CFR 892.2050; LLZ	21 CFR 892.2050; LLZ
Software Level of Concern	Moderate	Moderate

Intended Use:

Volpara is a software application intended for use with the raw data from digital breast xray systems, including tomosynthesis. Volpara calculates and quantifies a density map and from that determines volumetric breast density as a ratio of fibroglandular tissue and total breast volume estimates. Volpara provides these numerical values along with a Bl-RADS breast density 4th or 5th Edition category to aid health care professionals in the assessment of breast tissue composition. Volpara is not an interpretive or diagnostic aid and should be used only as adjunctive information when the final assessment of breast density category is made by an MQSA-qualified interpreting physician.

Device Description

volume of fibroglandular tissue in cm3, ●
volume of breast in cm3 ●
the volumetric breast density in %,
a BI-RADS 4th Edition or 5th Edition breast density category ●
average thickness of dense tissue
maximum thickness of dense tissue
maximum volume of dense tissue above any 1cm² square region ●

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Image /page/6/Picture/0 description: This image contains document information for a report. The report is titled "Volpara Imaging Software 510(k) Summary". The DMS number is mtk1956-007-6, the DMS reference is Eng/Angel, and the revision date is December 26th, 2015. This is page 4 of 5.

The device outputs those numbers along with the density maps themselves marked with the location of the various maxima.

Volpara operates on a Windows server that meets Volpara data input and output requirements and generally is located outside the patient environment. The device does not contact the patient, nor does it control any life-sustaining devices.

Performance Data

The Volpara software has been verified and validated according to the company's design control process. All of the documents specified in FDA's various software guidance documents have been submitted in the Special 510(k) Notification. A risk analysis compliant with ISO 14971 has been provided and incorporated into the development effort. Software testing included both unit level and integrated system level testing. A report of outstanding anomalies was included in the software information.

The modified device was tested and determined to be compliant to the following standards: ISO 14971:2012 Medical devices – Application of risk management to medical devices; 1SO 62304-2006 Software Life Cycle Processes, DICOM 2015.

In addition to the verification and validation testing conducted for the specific modification to the software detailed in this Special 510(k), complete verification and validation data testing conducted for the predicate was repeated in order to ensure integration and backwards compatibility.

Verification Bench Testing Included:

. Measurement accuracy was assessed by comparing Volpara estimates with known values from breast phantoms.
. Relationship to ground truth was assessed by running Volpara over x-ray images of breasts for which there was 3D breast MRI data available with a comparison of estimates of fibroglandular tissue.
Reproducibility was assessed by running Volpara over substantial datasets where ● we have the women's age and results compared with the expected and known decrease in breast density with age.
Reproducibility was assessed by running Volpara over substantial data sets and the results for left and right breasts and CC and MLO views were compared to confirm that the results were similar for each view and each breast.
. Reproducibility was assessed by running Volpara over substantial data sets where the same woman had been imaged on GE and Hologic systems one year apart and the results were compared to confirm they were similar.

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Image /page/7/Picture/0 description: The image is a logo for a company called "Mātakina Technology". The logo features a stylized crescent moon shape in light blue, with the company name written in a modern sans-serif font. The word "mātakina" is in a slightly larger font size than "technology", and there is a trademark symbol after the word "technology". The logo has a clean and professional look.

Reproducibility was assessed by running over substantial data sets where the . same woman had been imaged on one of GE, Hologic and Siemens tomosynthesis -compatible units running in both tomosynthesis and mammography modes, and the results were compared to confirm they were similar.
. Relationship to visual assessment was assessed by running Volpara over x-rav images for which a BI-RADS 4th and 5th Edition density category was available from MQSA qualified radiologists followed by a comparison of the two sets of data.

Clinical Validation Testing Included:

Beta site testing to assess the ability of physicians to successfully integrate the ● software into their existing systems as well as assess usability for target users
Beta site testing to collect minimum, average and maximum Volpara breast . densities and compare these to other existing databases

All verification and validation testing was successful in that established acceptance criteria was met for all of the tests conducted.

General Safety and Effectiveness Concerns:

The device labeling contains instructions for use and any necessary cautions and warnings to provide for safe and effective use of this device. Risk management is ensured via a risk analysis, which is used to identify potential hazards. These potential hazards are controlled via software development, verification and validation testing.

Conclusion:

The 510(k) Premarket Notification for Volpara contains adequate information and data to demonstrate substantial equivalence to the predicate device.

Regulation Number and Section

§ 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).