K Number
K171418
Device Name
1417WCC_127um and1417WCC_140um
Manufacturer
Date Cleared
2017-06-12

(28 days)

Product Code
Regulation Number
892.1680
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
1417WCC 127um and 1417WCC 140um are indicated for digital imaging solution designed for general radiographic system for human anatomy. It is intended to replace film or screen based radiographic systems in all general purpose diagnostic procedures. Not to be used for mammography
Device Description
While 1417WCC 127um digital X-ray detector is identical to 1417WCC (K141566), both 1417WCC 127 um and 1417WCC 140 um are wired/wireless digital solid state X-ray detectors that are based on flat-panel technology. The wireless LAN(IEEE 802.11a/g/n/ac) communication signals images captured to the system and improves the user operability through high-speed processing. These radiographic image detectors and processing unit consist of a scintillator coupled to an a-Si TFT sensor. These devices need to be integrated with a radiographic imaging system. Both devices do not operate as an X-ray generator controller but can be utilized to capture and digitalize X-ray images for radiographic diagnosis. The RAW files can be further processed as DICOM compatible image files by separate console SW (K160579 / Xmaru View V1 and Xmaru PACS/ Rayence Co.,Ltd.) for a radiographic diagnosis and analysis.
More Information

No
The description focuses on the hardware (detector technology) and basic image processing for DICOM compatibility. There is no mention of AI, ML, or any advanced algorithms that would typically be associated with such technologies for image analysis or interpretation.

No.
The device is described as a digital X-ray detector intended for diagnostic imaging, not for treatment or therapy.

Yes

The "Intended Use / Indications for Use" states that the device is "intended to replace film or screen based radiographic systems in all general purpose diagnostic procedures." Additionally, the "Device Description" mentions that the devices can be utilized "to capture and digitalize X-ray images for radiographic diagnosis."

No

The device description explicitly states it is a "wired/wireless digital solid state X-ray detector" based on flat-panel technology, which are hardware components.

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

Here's why:

  • IVD definition: In Vitro Diagnostics are medical devices used to examine specimens taken from the human body, such as blood, urine, or tissue, to provide information for diagnosis, monitoring, or screening.
  • Device function: The description clearly states that this device is a digital X-ray detector intended for capturing and digitalizing X-ray images of the human anatomy for general radiographic diagnosis. It works by detecting X-rays that pass through the body.
  • No specimen analysis: The device does not analyze any biological specimens taken from the body. It interacts with the body directly using X-rays.

Therefore, while it is a medical device used for diagnosis, it falls under the category of in vivo diagnostic imaging devices, not in vitro diagnostics.

N/A

Intended Use / Indications for Use

1417WCC 127um and 1417WCC 140um are indicated for digital imaging solution designed for general radiographic system for human anatomy. It is intended to replace film or screen based radiographic systems in all general purpose diagnostic procedures. Not to be used for mammography.

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

MOB, MQB

Device Description

While 1417WCC 127um digital X-ray detector is identical to 1417WCC (K141566), both 1417WCC 127 um and 1417WCC 140 um are wired/wireless digital solid state X-ray detectors that are based on flat-panel technology. The wireless LAN(IEEE 802.11a/g/n/ac) communication signals images captured to the system and improves the user operability through high-speed processing. These radiographic image detectors and processing unit consist of a scintillator coupled to an a-Si TFT sensor. These devices need to be integrated with a radiographic imaging system. Both devices do not operate as an X-ray generator controller but can be utilized to capture and digitalize X-ray images for radiographic diagnosis. The RAW files can be further processed as DICOM compatible image files by separate console SW (K160579 / Xmaru View V1 and Xmaru PACS/ Rayence Co.,Ltd.) for a radiographic diagnosis and analysis.

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

X-ray

Anatomical Site

human anatomy

Indicated Patient Age Range

Not Found

Intended User / Care Setting

General radiographic system

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 non-clinical test report and clinical consideration report for each subject device were prepared and submitted to FDA separately to demonstrate the substantial equivalency of the subject devices compared to each respective predicate device. The non-clinical test report contains the MTF, DQE and NPS test results of 1417WCC 140um by using the identical test equipment and same analysis method described by IEC 62220-1.

The MTF and DQE performance for 1417WCC_140μm detector and 1417WCA detector have been tested and compared. The MTF and DQE represent the ability to visualize object details of a certain size and contrast. 1417WCC 140um has similar MTF and DOE performance at all spatial frequencies, especially from 2 1p/mm to 3.5 lp/mm. The comparison of the MTF and DOE for both 1417WCC 140um detector an 1417WCA detector demonstrated that the 1417WCC_140μm performed almost same with 1417WCA.

To further demonstrate the substantial equivalency of two devices, clinical images are taken from both subject devices and reviewed by a licensed US doctor to render an expert opinion. Both the test subject (1417WCC_140μm) and the predicate devices (1417WCA) have been evaluated and compared by taking sample radiographs of similar age groups and anatomical structures in accordance with the test protocol of diagnostic radiography evaluation procedure.

After a broad review of plain radiographic images taken with the 1417WCC 140um the images obtained with the 1417WCC 140um are superior to the same view obtained from a similar patient with the predicate devices, 1417WCA. In general, both the spatial and soft tissue contrast resolution are superior using the 1417WCC 140um. Specifically, the soft tissues on extremity films were seen with better clarity. There is little difficulty in evaluating a wide range of anatomic structures necessary to provide a diagnostic review.

Based on the non-clinical and clinical consideration test and the outcome of a comparative review by an expert for both devices, the sponsor can claim the substantial equivalency between the subject devices and their predicate devices in terms of diagnostic image quality.

Electrical, mechanical, environmental safety and performance testing according to standard IEC 60601-1:2005 (3rd Edition) + CORR. 1:2006 + CORR. 2:2007 + A1:2012 (Medical electrical equipment Part 1:General requirements for basic safety and essential performance) was performed, and EMC testing were conducted in accordance with standard IEC 60601-1-2: 2007.

Non-clinical & Clinical considerations according to FDA Guidance for the Submissions of 510(k)'s for Solid State X-ray Imaging Devices" was performed.

All test results were satisfactory.

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.

K130935

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.

K141566

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

§ 892.1680 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/2 description: The image shows the seal of the Department of Health & Human Services (HHS) of the United States. The seal features the department's name encircling a symbol. The symbol consists of a stylized caduceus, which is a staff with two snakes entwined around it, overlaid with a human profile. The text reads "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA".

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

June 12, 2017

Rayence Co., Ltd % Dave Kim Medical Device Regulatory Affairs Mtech Group 8310 Buffalo Speedway Houston, Texas 77025

Re: K171418

Trade/Device Name: 1417WCC 127 μm and1417WCC 140 μm Regulation Number: 21 CFR 892.1680 Regulation Name: Stationary x-ray system Regulatory Class: Class II Product Code: MOB Dated: May 1, 2017 Received: May 15, 2017

Dear Dave 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

1

Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical devicerelated 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 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.

Michael D. O'Hara
For

Robert A. 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)

K171418

Device Name

1417WCC_127um and 1417WCC_140um

Indications for Use (Describe)

1417WCC 127um and 1417WCC 140um are indicated for digital imaging solution designed for general radiographic system for human anatomy. It is intended to replace film or screen based radiographic systems in all general purpose diagnostic procedures. Not to be used for mammography

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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1. 510(k) Summary

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

Date 510k summary prepared: June 7, 2017

Submitter's Name, address, telephone number, a contact person:

Submitter's Name :Rayence Co., Ltd.
Submitter's Address:14, Samsung 1-ro 1-gil, Hwaseong-si, Gyeonggi-do, Korea
Submitter's Telephone:+82-31-8015-6459
Contact person:Mr. Kee Dock Kim / RA Team Manager / +82-31-8015-6459
Official Correspondent:Dave Kim (davekim@mtech-inc.net)
Address:8310 Buffalo Speedway, Houston, TX 77025
Telephone:+713-467-2607
Fax:+713-583-8988

Name of the device, including the trade or proprietary name if applicable, the common or usual name and the classification name, if known:

Trade/proprietary name:1417WCC_127 µm and1417WCC_140 µm
Common Name: Digital Flat Panel X-ray Detector
Regulation Number: 21 CFR 892.1680
Regulation Name: Stationary X-ray System
Product Code: MQB
Predicate Device :
Trade/Device Name:1417WCA
Common Name: Digital Flat Panel X-ray Detector
510(k) Number: K130935
Regulation Number: 21 CFR 892.1680
Regulation Name: Stationary X-ray System
Product Code: MQB

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Reference Device:

Device: 1417WCC (Manufactured by Rayence
510(k) Number: K141566
Common Name: Digital Flat Panel X-ray Detector
Regulation Number: 21 CFR 892.1680
Regulation Name: Stationary X-ray System
Product Code: MQB

2. Device Description

While 1417WCC 127um digital X-ray detector is identical to 1417WCC (K141566), both 1417WCC 127 um and 1417WCC 140 um are wired/wireless digital solid state X-ray detectors that are based on flat-panel technology. The wireless LAN(IEEE 802.11a/g/n/ac) communication signals images captured to the system and improves the user operability through high-speed processing. These radiographic image detectors and processing unit consist of a scintillator coupled to an a-Si TFT sensor. These devices need to be integrated with a radiographic imaging system. Both devices do not operate as an X-ray generator controller but can be utilized to capture and digitalize X-ray images for radiographic diagnosis. The RAW files can be further processed as DICOM compatible image files by separate console SW (K160579 / Xmaru View V1 and Xmaru PACS/ Rayence Co.,Ltd.) for a radiographic diagnosis and analysis.

3. Indication for use

1417WCC 127 um and 1417WCC 140 um are indicated for digital imaging solution designed for general radiographic system for human anatomy. It is intended to replace film or screen based radiographic systems in all general purpose diagnostic procedures. Not to be used for mammography.

4. Summary of Design Control Risk management

1417WCC_127um digital X-ray detector is identical to 1417WCC (K141566). The 1417WCC_140μm digital X-ray detector is a modification of 1417WCA (K130935) developed for replacing a film detector for existing portable X-ray imaging systems. 1417WCC_140um adds portability with slightly thinner and lighter frame design compared to 1417WCA.

The risks and the hazardous impact of the device modification were analyzed with FMEA method. The specific risk control and protective measures to mitigate the risks from the modification were reviewed and implemented in the new product design phase. The overall assessment concluded that all risks and hazardous conditions identified arising from the design change were successfully mitigated and accepted.

5

5. Summary of the technological characteristics of the device compared to the predicate device:

1417WCC_127µm digital X-ray detector is identical to 1417WCC (K141566). Both 1417WCC_127 µm and 1417WCC_140 µm detectors described in this 510(k) have the same indications for use and similar technical characteristics as its predicate devices.

| Characteristic | Proposed
Ravence Co.,Ltd.
1417WCC 127 um and
1417WCC 140 um | | Predicate
Rayence Co.,Ltd.
1417WCA | | |
|----------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------|--------------------|
| Feature | | | | | |
| 510(k) number | | | K130935 | | |
| Intended Use | 1417WCC_127 um and 1417WCC_140
um are indicated for digital imaging
solution designed for general
radiographic system for human
anatomy. It is intended to replace film
or screen based radiographic systems in
all general purpose diagnostic
procedures. Not to be used for
mammography. | | 1417WCA Digital Flat Panel X-Ray
Detector is indicated for digital
imaging solution designed for
general radiographic system for
human anatomy. It is intended to
replace film or screen based
radiographic systems in all general
purpose diagnostic procedures. Not
to be used for mammography. | | Same |
| Detector Type | Amorphous Silicon, TFT | | Amorphous Silicon, TFT | | Same |
| Scintillator | 1417WCC 127μm
1417WCC_140um | CsI:Tl | 1417WCA | CsI:Tl | Same |
| Imaging Area | 14 x 17 inches | | 14 x 17 inches | | Same |
| Pixel matrix | 127 : 3328 X 2816
3328 x 2816
140 : 3052 X 2500 | | | Similar | |
| Pixel pitch | 127 um, 140 um | | 127 μm | | Same/
different |
| Resolution | 3.9 lp/mm | | 3.9 lp/mm | | Same |
| A/D conversion | 14 bit for 127 um / 16 bit for 140 um | | 14 bit | | Similar |
| Preview time | ≤2 seconds(wired / wireless) | | 23 seconds (wired) / 35 seconds
(wireless) | | Similar |
| Data output | RAW
*The RAW files are convertible into
DICOM 3.0 by console S/W | | RAW
*The RAW files are convertible into
DICOM 3.0 by console S/W | | Same |
| Dimensions | 460 × 384 × 15 mm | | 460 × 417 × 15.9 mm | | Similar |
| Weight | 3.0 kg (incl. battery) | | 3.9 kg (incl. battery) | | Similar |
| Application | General Radiology system or | | Wireless portable system | | Same |

Comparison table 5.1

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| | Wireless/Wired portable system
Available with upright stand, table,
universal stand. | Available with upright stand,
table, universal stand | |
|---------------------------------|--------------------------------------------------------------------------------------------|---------------------------------------------------------|---------|
| Added
Optional
Components | Battery & Battery Charger | Battery & Battery Charger | Similar |
| | Interface Box | | |
| | IrDA module | | |

5.2 Scintillator layer

*scintillator layer. ( * scintillator : a phosphor that produces scintillations)

ProposedPredicate
CsI (Cesium Iodide)1417WCC_127μm
1417WCC_140μm1417WCA

5.3 Added Optional Components (Comparison with Predicate device)

ComponentsDescription
Battery & Battery Charger
Image: Battery and Battery ChargerSources of electricity.
Mobile Battery Charger
Image: Mobile Battery Charger
Interface Box
Image: Interface Box1) Connector to synchronize the detector and generator.
  1. Data transfer and charging battery while the detector is in use
    (Connect between the detector and Interface Box), Up to three3) Transmitting an image/command between the detector and PC.
  2. Wireless AP. |
    | IrDA module
    Image: IrDA module | Sharing function for PC and detector. |

5.4 Recommended Generator Specifications

ModelManufactureSpecification
-----------------------------------

7

32kW40kW50kW
CMP 200Communications & Power
IndustrieskVp40-12540-150
mA10-40010-50010-630
EDITOR HFe 501Rontgenwerk BochumkVp40-150
mA10-630
UD150L-40E/40FShimadzukVp40-150
mA@100 kVp- 500(320)
@80 kVp- 630(400)
PXR-321BPoskom Co.,Ltd.kVp125/150
mA500

6. Summary of Performance Testing

1417WCC 127um digital X-ray detector is identical to 1417WCC (K141566). 1417WCC 127um and 1417WCC 140um Digital Flat Panel X-Ray Detectors have the same indications for use, the same imaging area (14 x 17), based on the same scintillator material (CsI:Tl ), the same resolution (3.9 lp/mm), performance, and safety characteristics compared to the predicate devices. The pixel matrix and pixel pitch sizes are different but the differences do not raise new concerns for the safety and effectiveness of the subject device.

The non-clinical test report and clinical consideration report for each subject device were prepared and submitted to FDA separately to demonstrate the substantial equivalency of the subject devices compared to each respective predicate device. The non-clinical test report contains the MTF, DQE and NPS test results of 1417WCC 140um by using the identical test equipment and same analysis method described by IEC 62220-1.

The MTF and DQE performance for 1417WCC_140μm detector and 1417WCA detector have been tested and compared. The MTF and DQE represent the ability to visualize object details of a certain size and contrast. 1417WCC 140um has similar MTF and DOE performance at all spatial frequencies, especially from 2 1p/mm to 3.5 lp/mm. The comparison of the MTF and DOE for both 1417WCC 140um detector an 1417WCA detector demonstrated that the 1417WCC_140μm performed almost same with 1417WCA.

8

To further demonstrate the substantial equivalency of two devices, clinical images are taken from both subject devices and reviewed by a licensed US doctor to render an expert opinion. Both the test subject (1417WCC_140μm) and the predicate devices (1417WCA) have been evaluated and compared by taking sample radiographs of similar age groups and anatomical structures in accordance with the test protocol of diagnostic radiography evaluation procedure.

After a broad review of plain radiographic images taken with the 1417WCC 140um the images obtained with the 1417WCC 140um are superior to the same view obtained from a similar patient with the predicate devices, 1417WCA. In general, both the spatial and soft tissue contrast resolution are superior using the 1417WCC 140um. Specifically, the soft tissues on extremity films were seen with better clarity. There is little difficulty in evaluating a wide range of anatomic structures necessary to provide a diagnostic review.

Based on the non-clinical and clinical consideration test and the outcome of a comparative review by an expert for both devices, the sponsor can claim the substantial equivalency between the subject devices and their predicate devices in terms of diagnostic image quality.

The manufacturing facility is in conformance with the design control procedure requirements specified in 21 CFR 820.30 and the relevant 21CFR820 standards as the records are available for review.

7. Summary for any testing in the submission:

Electrical, mechanical, environmental safety and performance testing according to standard IEC 60601-1:2005 (3rd Edition) + CORR. 1:2006 + CORR. 2:2007 + A1:2012 (Medical electrical equipment Part 1:General requirements for basic safety and essential performance) was performed, and EMC testing were conducted in accordance with standard IEC 60601-1-2: 2007.

Non-clinical & Clinical considerations according to FDA Guidance for the Submissions of 510(k)'s for Solid State X-ray Imaging Devices" was performed.

All test results were satisfactory.

8. Conclusions:

In accordance with the Federal Food, Drug and Cosmetic Act, 21 CFR Part 807 and based on the information provided in this premarket notification Rayence Co., Ltd. concludes that 1417WCC_127µm and 1417WCC_140um are substantially equivalent in comparison with the predicate devices.