K Number
K161419
Manufacturer
Date Cleared
2016-07-13

(51 days)

Product Code
Regulation Number
892.2050
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Multi Modality Viewer is a software application within Vitrea® that allows the examination and manipulation of a series of medical images obtained from MRI and CT scanners.

The option also enables clinicians to compare multiple series for the same patient, side-by-side, and switch to other integrated applications to further examine the data.

Device Description

Multi Modality Viewer is a software application which functions on the Vitrea Platform, cleared by K150258. This application allows intuitive navigation, and manipulation of medical images obtained from MRI and CT scanners. This application enables clinicians to compare multiple series of the same patient, side-by-side, and switch to other integrated applications to further examine the data.

lt provides clinical tools to review images to help qualified physicians provide efficient and effective patient care.

Key features:
General Viewing:

  • · Linked 2D, MPR and 4D viewers for single and multi-study comparison
  • · Creation of retrievable evidence and snapshots
  • · User defined flexible display protocols

Access to Advanced Applications and Workflows:

  • In application access to MR Stitching application
  • · Evidence creation and sharing across workflows

General Image Display, Manipulation, and Analysis Tools:

  • · Maximum and Minimum Intensity Projection (MIP/MinIP)
  • · Identification and Display of Regions of Interest (ROIs)
  • · CINE image display
  • · Multi-frame display
  • · Color image display
  • . Simultaneous multiple studies review
  • · Cross-reference lines support
  • Display of selected images, series, or entire study .
  • · Comparison of multiple series or studies
  • · Scroll
  • Pan
  • Zoom
  • · Focus
  • · Flip (Vertically, horizontally)
  • Invert
  • · Rotate (Clockwise, counter-clockwise)
  • · Arrow
  • · Adjust Registration
  • · Auto window level/width setting
  • · Text/Arrow annotation (Label)
  • · Measurement of distance (Ruler), Angle, Cobb Angle, Ellipse ROI, and Freehand ROI

Specialized Tools:

  • · Image subtraction of two series/datasets
  • · Access to semi-automated image stitching
  • Study and series linking .
  • · Register two different series or groups that do not share a frame of reference to link them spatially
AI/ML Overview

The Multi Modality Viewer is a software application for examining and manipulating medical images from MRI and CT scanners.

It is considered substantially equivalent to its predicate device, the MR Core Software (K151115), which only handled MRI images, and a reference device, Softread Software (K040305), which supports both CT and MRI.

Here's an analysis of the acceptance criteria and the study that proves the device meets them, based on the provided text:

1. Table of Acceptance Criteria and Reported Device Performance

The submission does not explicitly state quantitative acceptance criteria or a specific performance study comparison table for the Multi Modality Viewer beyond feature-by-feature comparison with predicate/reference devices. Instead, it focuses on demonstrating that the device has similar technological characteristics, intended use, and indications for use, and that verification and validation testing confirms its safety and effectiveness.

The document primarily performs a feature-by-feature comparison to establish substantial equivalence.

Criteria (for comparison/equivalence)Subject Device: Multi Modality ViewerPredicate Device: MR Core Software (K151115)Reference Device: Softread (K040305)Reported Performance (or comparison outcome)
Classification NameSystem, Image Processing, RadiologicalSystem, Image Processing, RadiologicalN/ASame
Regulatory Number892.2050892.2050N/ASame
Product CodeLLZLLZN/ASame
ClassificationClass IIClass IIN/ASame
Review PanelRadiologyRadiologyN/ASame
Indications for UseExamines/manipulates MRI and CT images; compares multiple series side-by-side.Examines/manipulates MRI images; compares multiple series side-by-side.N/AAdded CT support compared to predicate; similar to reference.
Intended UsersRadiologists, Clinicians, TechnologistsRadiologists, Clinicians, TechnologistsN/ASame
Patient PopulationNot applicable (viewer software)Not applicable (viewer software)N/ASame
Modality SupportCT and MRIMRICT and MRIAdded CT support compared to predicate; same as reference.
DICOM Image CommunicationYesYesYesSame
2D Image ReviewYesYesYesSame
2D Comparative ReviewYesYesYesSame
Multi-Planner ReformattingYesYesYesSame
MIP/MinIPYesYesYesSame
Image Editing, Setting, SavingYesYesYesSame
Annotation & Tagging ToolsYesYesYesSame
Display Options (e.g., thickness)YesYesYesSame
Quantitative MeasurementsYesYesYesSame
SnapshotYesYesYesSame
Cine Image DisplayYesYesYesSame
Multi-frame DisplayYesYesYesSame
Color Image DisplayYesYesYesSame
Simultaneous Multiple Studies ReviewYesYesYesSame
Cross-reference Lines SupportYesYesYesSame
Display of Selected Images/Series/StudyYesYesYesSame
Comparison of Multiple Series/StudiesYesYesYesSame
Scroll ImageYesYesYesSame
Zoom ImageYesYesYesSame
Pan ImageYesYesYesSame
Focus ImageYesYesYesSame
Rotate ImageYesYesYesSame
Flip Image - VerticalYesYesYesSame
Flip Image - HorizontalYesYesYesSame
Rotate Image - ClockwiseYesYesYesSame
Rotate Image - Counter-clockwiseYesYesYesSame
Invert ImageYesYesYesSame
ArrowYesYesYesSame
Auto Window Level/Width SettingYesYesYesSame
Measurement of DistanceYesYesYesSame
Measurement of AngleYesYesYesSame
Measurement of Cobb AngleYesYesYesSame
Identification & Display of Ellipse ROIsYesYesYesSame
Identification & Display of Freehand ROIsYesYesYesSame
Manual RegistrationYesYesYesSame
Image Subtraction of two series/datasetsYesYesYesSame
Study and Series LinkingYesYesYesSame
Semi-automated Image StitchingYesYesYesSame
Time Intensity AnalysisYesYesN/A (not listed for Softread)Same (comparison with predicate)
Batch Save of MPR reformatsYesYesN/A (not listed for Softread)Same (comparison with predicate)

Overall Conclusion: The device is considered substantially equivalent because the added CT modality feature is similar to the reference device and does not raise different questions of safety and effectiveness. The verification and validation testing performed "demonstrate the subject device is as safe and effective as the predicate and reference devices."

2. Sample Size for Test Set and Data Provenance

The document mentions "Verification of the software that included performance and safety testing" and "Validation of the software that included simulated usability testing by experienced professionals." However, it does not specify the sample size used for any test set or the country of origin of the data, nor whether it was retrospective or prospective. The information provided is high-level about the testing processes.

3. Number of Experts Used to Establish Ground Truth and Qualifications

For the "External Validation" mentioned under the "Validation" section, "experienced medical professionals evaluated the application." However, the exact number of experts and their specific qualifications (e.g., radiologist with 10 years of experience) are not specified.

4. Adjudication Method for the Test Set

The document does not describe any specific adjudication method (e.g., 2+1, 3+1) for establishing ground truth or evaluating the test set. It only states that "All validators confirmed that the Multi Modality Viewer software fulfills its intended use."

5. Multi Reader Multi Case (MRMC) Comparative Effectiveness Study

The document does not mention a Multi Reader Multi Case (MRMC) comparative effectiveness study and therefore, there is no information on the effect size of human readers improving with AI vs. without AI assistance. This device is a viewer, not an AI-assisted diagnostic tool in the sense of providing automated interpretations.

6. Standalone (Algorithm Only) Performance Study

The primary evaluation appears to be of the software's functionality as a viewer, not as an algorithm performing a specific diagnostic task in standalone mode. Verification and validation tests were conducted to confirm proper function of the device's features, but no standalone performance study measuring diagnostic accuracy or similar metrics for an algorithm without human-in-the-loop was reported.

7. Type of Ground Truth Used

The document indicates that "simulation usability testing by experienced professionals" and "workflow testing" were conducted, with "validators confirmed that the Multi Modality Viewer software fulfills its intended use." This suggests "expert consensus" on usability and fulfillment of intended use as the form of "ground truth" or validation outcome, rather than pathology, outcomes data, or a specific diagnostic ground truth, as the device is a viewing platform.

8. Sample Size for the Training Set

The document does not refer to a "training set" because the Multi Modality Viewer is described as a software application for viewing and manipulating images, not an AI/ML algorithm that requires a training set for model development.

9. How Ground Truth for Training Set Was Established

Since there is no mention of a training set, the method for establishing ground truth for a training set is not applicable or discussed.

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Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized graphic of three human profiles facing right, stacked on top of each other. The graphic is positioned inside a circular border, with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the border.

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

July 13, 2016

Vital Images, Inc. % Ms. Katie Ryan Regulatory Affairs Specialist 5850 Opus Parkway, Suite 300 MINNETONKA MN 55343-4414

Re: K161419

Trade/Device Name: Multi Modalitv Viewer Regulation Number: 21 CFR 892.2050 Regulation Name: Picture archiving and communications system Regulatory Class: II Product Code: LLZ Dated: May 20, 2016 Received: May 23, 2016

Dear Ms. Ryan:

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. 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

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Page 2-Ms. Katie Ryan

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

Robert Ochs, Ph.D. Director Division of Radiological Health Office of In Vitro Diagnostics and Radiological Health Center for Devices and Radiological Health

For

Enclosure

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Indications for Use

510(k) Number (if known) K161419

Device Name Multi Modality Viewer

Indications for Use (Describe)

Multi Modality Viewer is a software application within Vitrea® that allows the examination and manipulation of a series of medical images obtained from MRI and CT scanners.

The option also enables clinicians to compare multiple series for the same patient, side-by-side, and switch to other integrated applications to further examine the data.

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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510K Summary

This 510(k) summary is submitted in accordance with the requirements of 21 C.F.R. Part 807.92(c).

Basis for theSubmission:Vital Images, Inc. hereby submits this traditional 510(k) to obtain510(k) clearance for the Multi Modality Viewer software which issubstantially equivalent to the FDA cleared MR Core Software(K151115).
Submitter:Vital Images, Inc.5850 Opus Parkway, Suite 300Minnetonka, MN, 55343-4414
EstablishmentRegistration:2134213
Contact Person:Katie Ryan, M.S.Regulatory Affairs SpecialistPhone : 952-487-9793Fax: 952-487-9510E-mail: kryan@vitalimages.com
510(k) Type:Traditional
Summary Date:May 20, 2016
Device Trade Name:Multi Modality Viewer
Device CommonName/ RegulatoryDescription:Radiological Image Processing Software, Picture Archiving andCommunications System
Device ClassificationName:System, Image Processing, Radiological
Regulation Number:21 CFR 892.2050
Product Code:LLZ
RegulatoryClassification:Class II
Device Panel:Radiology

Predicate Device(s):

Predicate DeviceManufacturerFDA 510(k) Number
MR Core SoftwareVital Images, Inc.K151115

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Reference Device(s):

Reference DeviceManufacturerFDA 510(k) Number
Softread Software(Vitrea® 2, Version 3.5Medical Image ProcessingSoftware)Vital Images, Inc.K040305

Device Description:

Multi Modality Viewer is a software application which functions on the Vitrea Platform, cleared by K150258. This application allows intuitive navigation, and manipulation of medical images obtained from MRI and CT scanners. This application enables clinicians to compare multiple series of the same patient, side-by-side, and switch to other integrated applications to further examine the data.

lt provides clinical tools to review images to help qualified physicians provide efficient and effective patient care.

Key features:

General Viewing:

  • · Linked 2D, MPR and 4D viewers for single and multi-study comparison
  • · Creation of retrievable evidence and snapshots
  • · User defined flexible display protocols

Access to Advanced Applications and Workflows:

  • In application access to MR Stitching application
  • · Evidence creation and sharing across workflows

General Image Display, Manipulation, and Analysis Tools:

  • · Maximum and Minimum Intensity Projection (MIP/MinIP)
  • · Identification and Display of Regions of Interest (ROIs)
  • · CINE image display
  • · Multi-frame display
  • · Color image display
  • . Simultaneous multiple studies review
  • · Cross-reference lines support
  • Display of selected images, series, or entire study .
  • · Comparison of multiple series or studies
  • · Scroll
  • Pan
  • Zoom
  • · Focus
  • · Flip (Vertically, horizontally)
  • Invert
  • · Rotate (Clockwise, counter-clockwise)
  • · Arrow

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  • · Adjust Registration
  • · Auto window level/width setting
  • · Text/Arrow annotation (Label)
  • · Measurement of distance (Ruler), Angle, Cobb Angle, Ellipse ROI, and Freehand ROI

Specialized Tools:

  • · Image subtraction of two series/datasets
  • · Access to semi-automated image stitching
  • Study and series linking .
  • · Register two different series or groups that do not share a frame of reference to link them spatially

Intended Use / Indications for Use:

Multi Modality Viewer is a software application within Vitrea that allows the examination and manipulation of a series of medical images obtained from MRI and CT scanners.

The option also enables clinicians to compare multiple series for the same patient, side-by-side, and switch to other integrated applications to further examine the data.

Intended for Disease / Condition / Patient Population:

Multi Modality Viewer is medical image viewer software. Therefore, particular information of intended for disease, condition, and patient population is not applicable.

Substantial Equivalence Comparison:

Regulatory Comparison:

Subject DevicePredicate Device
CharacteristicMulti ModalityViewerMR CoreSoftware(K151115)Comparison
Classification NameSystem, ImageProcessing,RadiologicalSystem, ImageProcessing,RadiologicalSame
Regulatory Number892.2050892.2050Same
Product CodeLLZLLZSame
ClassificationClass IIClass IISame
Review PanelRadiologyRadiologySame
Decision DateUnder ReviewJune 3, 2015Predicate deviceis cleared
Subject DevicePredicate DeviceComparison
CriteriaMulti Modality ViewerMR Core Software(K151115)Comparison
Indications forUseMulti Modality Viewer isa software applicationwithin Vitrea® thatallows the examinationand manipulation of aseries of medicalimages obtained fromMRI and CT scanners.The option alsoenables clinicians tocompare multiple seriesfor the same patient,side-by-side, andswitch to otherintegrated applicationsto further examine thedata.MR Core is an optionwithin Vitrea® that allowsthe examination andmanipulation of a seriesof medical imagesobtained from MRIscanners.The option also enablesclinicians to comparemultiple series for thesame patient, side-by-side, and switch to otherintegrated applications tofurther exam the data.SimilarAdded support for theability to examine andmanipulate medicalimages obtained fromCT scanners was notpart of the predicatedevice's indications foruse.
Intended UsersRadiologists, Cliniciansor TechnologistsRadiologists, Clinicians orTechnologistsSame
PatientPopulationMulti Modality Viewer ismedical image viewersoftware. Therefore,particular information ofintended for disease,condition, and patientpopulation is notapplicable.MR Core Software ismedical image viewersoftware. Therefore,particular information ofintended for disease,condition, and patientpopulation is notapplicable.Same
ModalitySupportCT and MRIMRISimilarAdded support for theability to examine andmanipulate medicalimages obtained fromCT scanners was notpart of the predicatedevice's indications foruse.
Subject DevicePredicate Device
CriteriaMulti Modality ViewerMR Core Software(K151115)Comparison
Data Loading
ImageCommunicationStandard: DICOMYesYesSame
Data Viewing Support
2D Image ReviewYesYesSame
2D ComparativeReviewYesYesSame
Features and Capabilities
Multi-PlannerReformattingYesYesSame
Maximum andMinimum IntensityProjection(MIP/MinIP)YesYesSame
Image Editing,Setting, SavingYesYesSame
Annotation &Tagging Tools(Label)YesYesSame
Display Options(e.g. thickness)YesYesSame
QuantitativeMeasurementsYesYesSame
SnapshotYesYesSame
Cine Image DisplayYesYesSame
Multi-frame DisplayYesYesSame
Color Image DisplayYesYesSame
CriteriaSubject DevicePredicate Device
Multi Modality ViewerMR Core Software(K151115)Comparison
SimultaneousMultiple StudiesReviewYesYesSame
Cross-referenceLines SupportYesYesSame
Display of SelectedImages, Series, orEntire StudyYesYesSame
Comparison ofMultiple Series orStudiesYesYesSame
Scroll ImageYesYesSame
Zoom ImageYesYesSame
Pan ImageYesYesSame
Focus ImageYesYesSame
Rotate ImageYesYesSame
Flip Image - VerticalYesYesSame
Flip Image -HorizontalYesYesSame
Rotate Image -ClockwiseYesYesSame
Rotate Image -Counter-clockwiseYesYesSame
Invert ImageYesYesSame
ArrowYesYesSame
Auto WindowLevel/Width SettingYesYesSame
Measurement ofDistanceYesYesSame
Measurement ofAngleYesYesSame
CriteriaSubject DeviceMulti Modality ViewerPredicate DeviceMR Core Software(K151115)Comparison
Measurement ofCobb AngleYesYesSame
Identification andDisplay of EllipseRegions of Interest(ROIs)YesYesSame
Identification andDisplay of FreehandRegions of Interest(ROIs)YesYesSame
Manual RegistrationYesYesSame
Image subtraction oftwo series/datasetsYesYesSame
Study and SeriesLinkingYesYesSame
Semi-automatedimage stitchingYesYesSame
Time IntensityAnalysisYesYesSame
Batch Save ofMPR reformatsYesYesSame

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Indications for Use Comparison with Predicate Device:

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Similarities in Technology with Predicate Device:

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Image /page/10/Picture/1 description: The image shows the word "VITAL" in black font. The "i" in "VITAL" has a red dot above it. The font is sans-serif and the letters are evenly spaced. The image is simple and clean, with a focus on the word itself.

Subject DevicePredicate Device
CriteriaMulti Modality ViewerMR Core Software(K151115)Comparison
Feature: Support forCT Modality DataYesNoMulti Modality Viewerallows theexamination andmanipulation ofmedical imagesobtained from CTscanners in additionto MRI scanners.Note: The added CTModality feature issimilar to the featureavailable on VitalImage's Softreadsoftware ("ReferenceDevice"), which wascleared by the FDAunder K040305(Vitrea 2, Version 3.5Medical ImageProcessingSoftware). Therefore,this added featuredoes not raisedifferent questions ofsafety andeffectiveness.

Differences in Technology with the Predicate Device:

Similarities in Technology with the Reference Device:

CriteriaSubject DevicePredicate Device
Multi Modality ViewerSoftread (K040305)Comparison
Modality
Support for CT andMRI Modality DataYesYesSame
Data Loading
ImageCommunicationStandard: DICOMYesYesSame
Data Viewing Support
Subject DevicePredicate Device
CriteriaMulti Modality ViewerSoftread (K040305)Comparison
2D Image ReviewYesYesSame
2D ComparativeReviewYesYesSame
Features and Capabilities
Multi-PlannerReformattingYesYesSame
Maximum andMinimum IntensityProjectionYesYesSame
Image Editing,Setting, SavingYesYesSame
Annotation & TaggingTools (Label)YesYesSame
Display Options (e.g.thickness)YesYesSame
QuantitativeMeasurementsYesYesSame
SnapshotYesYesSame
Cine Image DisplayYesYesSame
Multi-frame DisplayYesYesSame
Color Image DisplayYesYesSame
SimultaneousMultiple StudiesReviewYesYesSame
Cross-referenceLines SupportYesYesSame
Display of SelectedImages, Series, orEntire StudyYesYesSame
Comparison ofMultiple Series orStudiesYesYesSame
Scroll ImageYesYesSame
Zoom ImageYesYesSame

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Image /page/11/Picture/0 description: This image contains text related to medical device regulatory processes. The text "Multi Modality Viewer" appears at the top, followed by "Traditional 510(k) Pre-market Notification" on the next line. This suggests the image is related to the FDA's 510(k) pre-market notification process for medical devices, specifically in the context of multi-modality viewers.

Image /page/11/Picture/5 description: The image shows the word "VITAL" in a bold, sans-serif font. The letters are black, except for the dot above the "i", which is red. The letters are evenly spaced and the word is centered.

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Image /page/12/Picture/0 description: The image contains text that appears to be part of a document or presentation. The text includes "Multi Modality Viewer" on the first line, followed by "Traditional 510(k) Pre-market Notification" on the second line. The text is left-aligned and appears to be a title or heading for the document.

CriteriaSubject DevicePredicate Device
Multi Modality ViewerSoftread (K040305)Comparison
Pan ImageYesYesSame
Focus ImageYesYesSame
Rotate ImageYesYesSame
Flip Image - VerticalYesYesSame
Flip Image -HorizontalYesYesSame
Rotate Image -ClockwiseYesYesSame
Rotate Image -Counter-clockwiseYesYesSame
Invert ImageYesYesSame
ArrowYesYesSame
Auto WindowLevel/Width SettingYesYesSame
Measurement ofDistanceYesYesSame
Measurement ofAngleYesYesSame
Measurement ofCobb AngleYesYesSame
Identification andDisplay of EllipseRegions of Interest(ROIs)YesYesSame
Identification andDisplay of FreehandRegions of Interest(ROIs)YesYesSame
Manual RegistrationYesYesSame
Image subtraction oftwo series/datasetsYesYesSame
Study and SeriesLinkingYesYesSame

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Summary of Non-Clinical Tests:

The Multi Modality Viewer software was designed, and tested according to written procedures that included risk management. Software testing was completed to ensure the new features operate according to defined requirements.

The following design control measures were applied to the development of the Multi Modality Viewer software:

  • Risk Management ●
  • Requirements Reviews ●
  • Code Designs ●
  • Code Development Testing
  • Code Reviews ●
  • Design Reviews ●
  • Verification of the software that included performance and safety testing ●
  • Validation of the software that included simulated usability testing by experienced ● professionals.

Risk Management:

Each risk pertaining to these features have been individually assessed to determine if the benefits outweigh the risk. Every risk has been reduced as low as possible and has been evaluated to have a probability of occurrence of harm of at least "Improbable." All risks for this feature were collectively reviewed to determine if the benefits outweigh the risk. Because of the risk control measures included in this feature, it is believed that the risk for the feature as a whole is extremely low. Taking into account all risks against the benefits of this feature, it has been assessed that the benefits do outweigh the risks for this feature.

During the design review, the following conclusions were reached:

  • All Occurrence Factors for Hazards were mitigated as low as possible ●
  • Of the unresolved defects remaining in the released application, each has been carefully . evaluated and it has been determined that the software can be used safely and effectively.
  • . The medical benefits of the device outweigh the residual risk for each individual risk and all risks together.

Verification:

The software verification team's primary goal was to assure that the software fully satisfies all expected system requirements and features. Test cases were executed against the system features and requirements. As a part of creating the test cases, the verification team reviewed and monitored the Requirements Traceability Matrix ("RTM") to ensure coverage of the items within the RTM.

Validation:

The software validation team's primary goal was assuring the software conforms to user needs and intended use. The validation team conducted workflow testing that provided evidence that the system requirements and features were implemented, reviewed and met.

External Validation:

During external validation of the Multi Modality Viewer software, experienced medical professionals evaluated the application. All validators confirmed that the Multi Modality Viewer software fulfills its intended use.

010 510(k) Summary

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Summary of Clinical Tests:

The subject of this 510(k) notification, Multi Modality Viewer software, did not require clinical studies to support safety and effectiveness of the software.

Cyber and Information Security:

Confidentiality

The Vitrea platform (K150258) relies on built in Windows Login security to limit access to the system. The Vitrea platform can only be installed and configured by an administrator of the Windows machine.

Integrity

The Vitrea platform complies with the DICOM standard for transfer and storage of this data and does not modify the contents of DICOM instances. New DICOM produced by Vitrea is identified as such with the appropriate manufacturer tags per the DICOM standard.

Availability

The Vitrea platform is always available to the logged on user as long as the Windows machine itself is properly maintained.

Accountability

The Vitrea platform includes an audit capability that enables accountability by tracking authenticated and authorized user operations along with information accessed. Vitrea audit logs are time stamped, enabling correlation with Windows system logging to track information accessed by a user.

Performance Standards:

The FDA has not established mandatory performance standards and no special controls exist for this device. General software verification and validation tests were conducted to confirm proper function of the device's features.

Standard No.Standards OrganizationStandard TitleVersionDate
PS 3.1- 3.20 (2011) (Recognition Number 12-238)NEMADigital Imaging and Communications in Medicine (DICOM) Set (Radiology)303/16/2012
ISO 14971:2007 (Recognition Number 5-70)AAMI / ANSI / ISOMedical Devices - Applications of Risk Management to Medical Devices200703/16/2012
IEC 62304:2006 (Recognition Number 13-32)AAMI / ANSI / IECMedical Device Software - Software Life Cycle Processes (Software / Informatics)200608/20/2012

The Vitrea software complies with the following voluntary recognized consensus standards:

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Substantial Equivalence Analysis Conclusion:

Multi Modality Viewer is a software application within Vitrea that allows for the examination and manipulation of a series of medical images obtained from MRI and CT scanners. Vital Images believes the Multi Modality Viewer software application has a similar intended use, indications for use, principle of operation, and technological characteristics as the legally marketed, predicate device MR Core Software (K151115). In addition, the CT Modality feature is similar to the feature in the reference device, Softread, which was cleared by the FDA under K040305 (Vitrea 2, Version 3.5 Medical Image Processing Software).

Furthermore, the verification and validation testing performed demonstrate the subject device is as safe and effective as the predicate and reference devices and does not raise any different questions of safety and effectiveness. Therefore, Vital believes the addition of the CT Modality feature in the Multi Modality Viewer software does not alter the fundamental scientific technology, safety or intended use of the device.

Any noted minor differences have been explained and do not raise any different questions of safety or effectiveness when used as labeled. The implemented design controls, risk management activities, labeling, and performed verification tests demonstrate the safety and efficacy of the subject device. Based on the comparison information provided above, Vital Images believes the subject device should be found substantially equivalent to the predicate device.

§ 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).