K Number
K160997
Device Name
GC85A
Date Cleared
2016-07-06

(86 days)

Product Code
Regulation Number
892.1680
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The GC85A Digital X-ray Imaging System is intended for use in generating radiographic images of human anatomy by a qualified/trained doctor or technician. This device is not intended for mammographic applications. The SimGrid is a technology that enhances the visibility of major clinical equipment by compensating for the decrease in contrast that is caused by scatter radiation when the portable grid is not used for portable images. Bone Suppression is a technology that helps to create images with good lung field visibility by removing part of the ribs and clavicle with S/W algorithms. It is used as diagnosis assistance for areas that the image reader is interested in, such as soft tissues and lesions in the lung field.
Device Description
The GC85A digital X-ray imaging system is used to capture images by transmitting Xray to a patient's body. The X-ray passing through a patient's body is sent to the detector and then converted into electrical signals. These signals go through the process of amplification and digital data conversion in the signal process device before being sent to the S-Station (Operation Software) and saved in DICOM file, a standard for medical imaging. The captured images are sent to the Picture Archiving & Communication System (PACS) server, and can be used for reading images. The SimGrid is a post-image processing software option which is able to compensate the contrast loss due to scatter radiations, primarily acquisitions without a physical antiscatter grid. The Bone Suppression Image (BSI) is a post-image processing software option which provides companion images to assist diagnosis in addition to the images obtained from normal diagnosis protocol. The BSI software option suppresses bone anatomy to enhance visualization of chest pathology in a companion image that is delivered in addition to the original diagnostic image. The SimGrid and BSI are available as options to be exclusively installed in S-station, which is a Samsung Digital X-ray operation S/W, since this post-image processing software does not depend on how the image is acquired, or with what acquisition device.
More Information

Not Found

No
The description mentions "S/W algorithms" for Bone Suppression, but does not explicitly state or imply the use of AI or ML techniques. The performance studies focus on traditional imaging metrics and qualitative evaluations by radiologists, without mentioning AI/ML-specific performance metrics or training/test data descriptions.

No
The device is an X-ray imaging system and related software for generating and enhancing radiographic images for diagnostic purposes, not for direct therapeutic treatment.

Yes

The "Intended Use / Indications for Use" section states: "Bone Suppression...is used as diagnosis assistance for areas that the image reader is interested in, such as soft tissues and lesions in the lung field." and the "Device Description" section states: "The BSI software option suppresses bone anatomy to enhance visualization of chest pathology in a companion image that is delivered in addition to the original diagnostic image." This clearly indicates its role in aiding diagnosis.

No

The device description clearly states that the GC85A is a digital X-ray imaging system which includes hardware components like an X-ray transmitter, detector, signal process device, and the S-Station (Operation Software). While SimGrid and Bone Suppression are software options, they are part of a larger hardware system.

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

Here's why:

  • IVD Definition: In Vitro Diagnostic devices are used to examine specimens taken from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening.
  • Device Function: The GC85A Digital X-ray Imaging System, SimGrid, and Bone Suppression are all involved in generating and processing radiographic images of the human body. They work by transmitting X-rays through the patient and capturing the resulting image.
  • No Specimen Analysis: There is no mention of analyzing any biological specimens taken from the patient. The entire process is focused on imaging the internal structure of the body.

Therefore, the device falls under the category of medical imaging devices, not In Vitro Diagnostics.

N/A

Intended Use / Indications for Use

The GC85A Digital X-ray Imaging System is intended for use in generating radiographic images of human anatomy by a qualified/trained doctor or technician. This device is not intended for mammographic applications.

The SimGrid is a technology that enhances the visibility of major clinical equipment by compensating for the decrease in contrast that is caused by scatter radiation when the portable grid is not used for portable images.

Bone Suppression is a technology that helps to create images with good lung field visibility by removing part of the ribs and clavicle with S/W algorithms. It is used as diagnosis assistance for areas that the image reader is interested in, such as soft tissues and lesions in the lung field.

Product codes

KPR

Device Description

The GC85A digital X-ray imaging system is used to capture images by transmitting Xray to a patient's body. The X-ray passing through a patient's body is sent to the detector and then converted into electrical signals. These signals go through the process of amplification and digital data conversion in the signal process device before being sent to the S-Station (Operation Software) and saved in DICOM file, a standard for medical imaging. The captured images are sent to the Picture Archiving & Communication System (PACS) server, and can be used for reading images.

The SimGrid is a post-image processing software option which is able to compensate the contrast loss due to scatter radiations, primarily acquisitions without a physical antiscatter grid.

The Bone Suppression Image (BSI) is a post-image processing software option which provides companion images to assist diagnosis in addition to the images obtained from normal diagnosis protocol. The BSI software option suppresses bone anatomy to enhance visualization of chest pathology in a companion image that is delivered in addition to the original diagnostic image.

The SimGrid and BSI are available as options to be exclusively installed in S-station, which is a Samsung Digital X-ray operation S/W, since this post-image processing software does not depend on how the image is acquired, or with what acquisition device.

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

X-ray

Anatomical Site

human anatomy, chest, lung field

Indicated Patient Age Range

Not Found

Intended User / Care Setting

qualified/trained doctor or technician

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

SimGrid software was evaluated with various phantoms at various exposure conditions to demonstrate that SimGrid processing gives the better local contrast than images acquired without a grid. The qualitative side including usefulness was validated by a radiographer using clinical images which was proved in 'Clinical data' section.

BSI software was evaluated with various kinds of clinical images, such as with various sizes of patients at various exposure conditions, by a professional radiologist.

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Clinical image evaluations were performed in accordance with FDA guidance for the submission of 510(k)'s for Solid State X-ray Imaging Devices. They were evaluated by a professional radiologist and found to be equivalent to the predicate devices.

Overall quality of the bone suppressed images was found to be useful as diagnosis assistance for areas that the reader is interested in, such as soft tissues and lesions in the lung field.

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

Not Found

Predicate Device(s)

K150165, K141765, K141837

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 892.1680 Stationary x-ray system.

(a)
Identification. A stationary x-ray system is a permanently installed diagnostic system intended to generate and control x-rays for examination of various anatomical regions. This generic type of device may include signal analysis and display equipment, patient and equipment supports, component parts, and accessories.(b)
Classification. Class II (special controls). A radiographic contrast tray or radiology diagnostic kit intended for use with a stationary x-ray system only is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 892.9.

0

Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized image of an eagle.

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

July 6, 2016

Samsung Electronics Co., Ltd. % Mr. Chulsin Kim Regulatory Affairs Manager 129, Samsung-ro, Yeongtong-gu Suwon-si, Gyeonggi-do 443-742 REPUBLIC OF KOREA

Re: K160997

Trade/Device Name: GC85A Regulation Number: 21 CFR 892.1680 Regulation Name: Stationary x-ray system Regulatory Class: II Product Code: KPR Dated: April 7, 2016 Received: April 11, 2016

Dear Mr. Kim:

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.

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

2

Indications for Use

510(k) Number (if known) K160997

Device Name GC85A

Indications for Use (Describe)

The GC85A Digital X-ray Imaging System is intended for use in generating radiographic images of human anatomy by a qualified/trained doctor or technician. This device is not intended for mammographic applications.

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)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

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

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

3

Image /page/3/Picture/1 description: The image shows the Samsung logo. The logo is in blue and features the word "SAMSUNG" in white, uppercase letters. The logo is tilted slightly upwards.

510(k) Premarket Notification - Traditional

Section 5: 510(k) Summary

This summary of 510(k) safety and effectiveness information is being submitted accordance with requirements of 21 CFR 807.92

    1. Date: April 07, 2016

2. Submitter

  • Company Name: SAMSUNG ELECTRONICS Co., Ltd. A.
  • Address: 129, Samsung-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, 443-742, B. Republic of Korea

3. Primary Contact Person

  • Name: KIM, CHULSIN A.
  • B. Title: Regulatory Affairs Manager
  • C. Phone Number: +82-31-200-7661
  • FAX Number: +82-31-200-1199 D. E-Mail: chulsin.kim@samsung.com

4. Secondary Contact Person

  • A. Name: Ninad Gujar
  • B. Title: Regulatory Affairs Manager
  • C. Phone Number: 978-564-8503
  • FAX Number: 978-750-6677 D. E-Mail: ngujar@samsungneurologica.com

5. Proposed Device

  • A. Trade Name: GC85A
  • B. Device Name: GC85A
  • C. Common Name: Digital Diagnostic X-ray System
  • D. Classification Name: System, X-ray, Stationary
  • E. Product Code: KPR
  • Regulation: 21 CFR 892.1680 ட்

6. Predicate Devices

Predicate Device #1Predicate Device #2Predicate Device #3
Device NameGC85AFDR D-EVO FLAT
PANEL DETECTOR
SYSTEMDRX-EVOLUTION
Classification
NameStationary X-ray
SystemStationary x-ray
system.Stationary x-ray
system.
Product CodeKPRMQBKPR
Regulation21 CFR 892.168021 CFR 892.168021 CFR 892.1680
510(K)#K150165K141765K141837
510(K)April 02, 2015October 03, 2014March 11, 2015

4

510(k) Premarket Notification - Traditional

Decision Date

7. Device Description

The GC85A digital X-ray imaging system is used to capture images by transmitting Xray to a patient's body. The X-ray passing through a patient's body is sent to the detector and then converted into electrical signals. These signals go through the process of amplification and digital data conversion in the signal process device before being sent to the S-Station (Operation Software) and saved in DICOM file, a standard for medical imaging. The captured images are sent to the Picture Archiving & Communication System (PACS) server, and can be used for reading images.

The SimGrid is a post-image processing software option which is able to compensate the contrast loss due to scatter radiations, primarily acquisitions without a physical antiscatter grid.

The Bone Suppression Image (BSI) is a post-image processing software option which provides companion images to assist diagnosis in addition to the images obtained from normal diagnosis protocol. The BSI software option suppresses bone anatomy to enhance visualization of chest pathology in a companion image that is delivered in addition to the original diagnostic image.

The SimGrid and BSI are available as options to be exclusively installed in S-station, which is a Samsung Digital X-ray operation S/W, since this post-image processing software does not depend on how the image is acquired, or with what acquisition device.

8. Intended Use

The GC85A Digital X-ray Imaging System is intended for use in generating radiographic images of human anatomy by a qualified/trained doctor or technician. This device is not intended for mammographic applications.

The SimGrid is a technology that enhances the visibility of major clinical equipment by compensating for the decrease in contrast that is caused by scatter radiation when the portable grid is not used for portable images.

Bone Suppression is a technology that helps to create images with good lung field visibility by removing part of the ribs and clavicle with S/W algorithms. It is used as diagnosis assistance for areas that the image reader is interested in, such as soft tissues and lesions in the lung field.

9. Summary of Technological characteristic of the proposed device compared with the predicate devices

The proposed device, GC85A, has the same technological characteristics as its original predicate device, GC85A (K150165), and adds two post-image processing software features, SimGrid and BSI(Bone Suppression Image), and other minor software features such as S-Align & S-Guide, and hardware such as a collimator and a weight distribution cap. All features do not have significant change in materials, energy source or technological characteristics compared to the predicate devices #1, 2 & 3.

A. Comparing with Predicate Device #1

SpecificationPredicate Device #1Proposed DeviceDiscussion
-----------------------------------------------------------------

5

Image /page/5/Picture/1 description: The image shows the SAMSUNG logo. The logo is in white text on a blue background. The logo is tilted slightly to the right.

510(k) Premarket Notification - Traditional

Device NameGC85AGC85A-
ManufacturerSAMSUNG ELECTRONICS
co., ltd.SAMSUNG ELECTRONICS
co., ltd.-
510(k)
NumberK150165None-
AppearancesImage: x-rayImage: x-raySame
Intended UseThe GC85A digital X-ray
imaging system is intended
for use in generating
radiographic images of
human anatomy by a
qualified/trained doctor or
technician. This device is not
intended for mammographic
applications.The GC85A Digital X-ray
Imaging System is intended
for use in generating
radiographic images of
human anatomy by a
qualified/trained doctor or
technician. This device is not
intended for mammographic
applications.Same
Collimator*NOTE: SDR-OGCL80U was cleared with K150165
Model
NamesSDR-OGCL80USDR-
OGCL80USDR-
OGCL83U
Overall
size(mm)H212 X W300
X D179H212 X
W300
X D179H212 X
W306
X D179Difference(1)
Weight Distribution Cap
Model NameNoneSDR-OGWD80U
W x L x H(mm):
505x553x37.4Difference(2)
Software Features
Feature
NamesNoneS-Align & S-GuideDifference(3)
NoDifferencesExplanation
(1)Collimator
Overall SizeThe new SDR-OGCL83U collimator has 6mm wider width than the
predicate device's collimator. It does not contribute adverse
impacts to the device safety and performance.
(2)Weight
Distribution CapAs an accessory, it is introduced to prevent the detector from being
damaged by excessive force, which does not contribute adverse
impacts to the device safety and performance.
(3)S-Align & S-
GuideS-Align is to display the tilt angle of the portable detector, and S-
guide is to display the values (stitching areas) required for image
capturing. Both don't contribute adverse impacts to the device
safety and performance.

6

Image /page/6/Picture/1 description: The image shows the SAMSUNG logo. The logo is in white text on a blue oval background. The text is in a bold, sans-serif font.

510(k) Premarket Notification - Traditional

B. Comparing with Predicate Device #2

B. Comparing with Predicate Device #2
SpecificationPredicate Device #2Proposed DeviceDiscussion
Device NameFDR D-EVO FLAT PANEL
DETECTOR SYSTEMGC85A-
ManufacturerFUJIFILM Medical Systems
U.S.A Inc.SAMSUNG ELECTRONICS
co., ltd.-
510(k)
NumberK141765None-
Intended UseThe Wireless/Wired FDR D-
EVO flat panel detector
system is intended to
capture for display
radiographic images of
human anatomy. It is
intended for use in general
projection radiographic
applications including
pediatric and neonatal
exams wherever
conventional film/screen or
CR systems may be used.
The FDR D-EVO is not
intended for mammography,
fluoroscopy, tomography,
and angiography
applications.The GC85A Digital X-ray
Imaging System is intended
for use in generating
radiographic images of
human anatomy by a
qualified/trained doctor or
technician. This device is not
intended for mammographic
applications.Difference(1)
S/W Feature
NameVirtual Grid SoftwareSimGrid-
S/W
descriptionThe Virtual Grid Software is
designed to improve image
contrast in general
radiographic images by
reducing the effects of
scatter radiation, primarily
for exams acquired without a
gridThe SimGrid is a technology
that enhances the visibility of
major clinical equipment by
compensating for the
decrease in contrast that is
caused by scatter radiation
when the portable grid is not
used for portable imagesSame
NoDifferencesExplanation
(1)Intended UseThe intended use of both devices is different, but the s/w feature's application is same as the post-image processing software, which does not contribute adverse impacts to the device safety and performance.

C. Comparing with Predicate Device #3

SpecificationPredicate Device #3Proposed DeviceDiscussion
Device NameDRX-EVOLUTIONGC85A-

7

Image /page/7/Picture/1 description: The image shows the Samsung logo. The word "SAMSUNG" is written in white, bold letters against a blue background. The logo has a slightly curved shape, with the top and bottom edges of the blue background curving inward.

510(k) Premarket Notification - Traditional

| Manufacturer | FUJIFILM Medical Systems
U.S.A Inc. | SAMSUNG ELECTRONICS
co., ltd. | - | No | Differences | Explanation |
|---------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------|-----|--------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 510(k)
Number | K141837 | None | - | (1) | Intended Use | The intended use of both devices is different, but the s/w feature's
application is same as the post-image processing software, which
does not contribute adverse impacts to the device safety and
performance. |
| Intended Use | The device is a permanently
installed diagnostic x-ray
system for general
radiographic x-ray imaging
including tomography. The
tomography feature is not to
be used for imaging pediatric
patients. | The GC85A Digital X-ray
Imaging System is intended
for use in generating
radiographic images of
human anatomy by a
qualified/trained doctor or
technician. This device is not
intended for mammographic
applications. | Difference(1) | | | |
| S/W Feature
Name | Bone Suppression | Bone Suppression Image | - | | | |
| S/W
description | Bone Suppression can
improve visibility of lung
nodules and other pathology
by suppressing the
appearance of posterior ribs
and clavicles. | Bone Suppression is a
technology that helps to
create images with good
lung field visibility by
removing part of the ribs and
clavicle with S/W algorithms.
It is used as diagnosis
assistance for areas that the
image reader is interested
in, such as soft tissues and
lesions in the lung field. | Same | | | |

10. Safety, EMC and Performance Data

Electrical, mechanical, environmental safety and performance testing according to standard ES 60601-1,IEC 60601-1-2, IEC 60601-1-3, IEC 60601-2-28, IEC 60601-2-54, ISO14971, 21CFR1020.30 and 21CFR1020.31 were performed, and EMC testing was conducted in accordance with standard IEC 60601-1-2. Wireless function was tested and verified followed by guidance, Radio frequency Wireless Technology in Medical Devices. All test results were satisfying the standards.

11. Non-clinical data

Non-clinical testing data was provided in conformance to the FDA "Guidance for the Submission of 510(k)'s for Solid-State X-ray Imaging Devices", which includes MTF and DQE measurements as tested by IEC 62220-1.

The proposed device shows no difference in non-clinical testing data such as MTF and

8

Image /page/8/Picture/1 description: The image shows the Samsung logo. The word "SAMSUNG" is written in white, bold letters. The background is a blue, rounded rectangle.

510(k) Premarket Notification - Traditional

DQE measurements from the predicate device #1.

SimGrid software was evaluated with various phantoms at various exposure conditions to demonstrate that SimGrid processing gives the better local contrast than images acquired without a grid. The qualitative side including usefulness was validated by a radiographer using clinical images which was proved in 'Clinical data' section.

12. Clinical data

In clinical data, clinical image evaluations were performed in accordance with FDA guidance for the submission of 510(k)'s for Solid State X-ray Imaging Devices. They were evaluated by a professional radiologist and found to be equivalent to the predicate devices.

BSI software was evaluated with various kinds of clinical images, such as with various sizes of patients at various exposure conditions, by a professional radiologist. Overall quality of the bone suppressed images was found to be useful as diagnosis assistance for areas that the reader is interested in, such as soft tissues and lesions in the lung field.

13. Conclusions

The non-clinical and clinical data demonstrate that the proposed device is as safe, as effective, and performs as well as the legally marketed devices.