K Number
K181247
Manufacturer
Date Cleared
2018-11-20

(194 days)

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

Vitrea CT Brain Perfusion is a non-invasive post-processing application designed to evaluate areas of brain perfusion. The software can calculate cerebral blood flow (CBF), cerebral blood volume (CBV), local bolus timing (i.e., delay of tissue response, time to peak), and mean transit time (MTT) from dynamic CT image data acquired after the injection of contrast media. The package also allows the calculation of regions of interest and mirrored regions, as well as the visual inspection of time density curves. Vitrea CT Brain Perfusion supports the physician in visualizing the apparent blood perfusion in brain tissue affected by acute stroke. Areas of decreased perfusion, as is observed in acute cerebral infarcts, appear as areas of changed signal intensity (lower for both CBF and CBV and higher for time to peak and MTT).

Device Description

Vitrea CT Brain Perfusion is a noninvasive post-processing software that calculates cerebral blood flow (CBF), cerebral blood volume (CBV), local bolus timing (i.e., delay of tissue response, time to peak), and mean transit time (MTT) from dynamic CT image data. It displays time density curves, perfusion characteristics in perfusion and summary maps, as well as regions of interest and mirrored regions.

AI/ML Overview

Here's an analysis of the acceptance criteria and study information for the Vitrea CT Brain Perfusion device, based on the provided text:

1. Table of Acceptance Criteria and Reported Device Performance

The provided document does not explicitly state quantitative acceptance criteria or a direct performance table for the Vitrea CT Brain Perfusion device with the Bayesian algorithm. Instead, the document focuses on demonstrating substantial equivalence to a previously cleared predicate device (Vitrea CT Brain Perfusion with SVD+ algorithm, K121213) and reference device (Olea Sphere V3.0, K152602) due to the addition of a Bayesian algorithm.

The core "acceptance" is based on the conclusion that the new device is "as safe and effective" as the predicate. This is supported by:

  • "Algorithm Testing": "The Vitrea CT Brain Perfusion Bayesian algorithm has passed all the verification and validation and is therefore considered validated and acceptable."
  • "External Validation": "Based on the scores provided by the physicians, Vital concluded the Brain Perfusion with Bayesian algorithm is as safe and effective as the already cleared Brain Perfusion with SVD+ algorithm and fulfills its intended use."

While direct numerical performance metrics are not given, the implicit acceptance criteria are that the device's output (CBF, CBV, TTP, MTT maps and calculations) is comparable and clinically acceptable to that generated by the predicate device, especially in its ability to support the physician in visualizing perfusion in acute stroke.

2. Sample Size Used for the Test Set and Data Provenance

The document mentions "External Validation" where "physicians evaluated if the Brain Perfusion with Bayesian algorithm (subject device) was substantially equivalent with the Brain Perfusion with SVD+ algorithm (K121213, predicate device)." However, the specifics of the test set, including:

  • Sample size: Not explicitly stated (e.g., number of patients/cases).
  • Data provenance (country of origin, retrospective/prospective): Not explicitly stated.

3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications

  • Number of experts: Not explicitly stated how many "physicians" were involved in the "External Validation."
  • Qualifications of experts: The document only refers to them as "physicians." Specific qualifications (e.g., "radiologist with 10 years of experience") are not provided.

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 physician scores in the "External Validation." It simply states that "Based on the scores provided by the physicians, Vital concluded..."

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

  • Was an MRMC study done? While an "External Validation" involving "physicians" was performed, the document does not explicitly label it as a formal MRMC comparative effectiveness study in the way this term is typically used for AI-assisted workflows (i.e., comparing human readers with and without AI assistance). The focus was on comparing the Bayesian algorithm's outputs to the predicate's SVD+ algorithm's outputs, as judged by physicians.
  • Effect size of human improvement with AI vs. without AI assistance: Not reported, as the study was not framed as a human-in-the-loop improvement study.

6. Standalone (Algorithm Only) Performance

  • Was a standalone study done? Yes, the document heavily implies that the "Algorithm Testing" and subsequent "External Validation" primarily focused on the standalone performance of the Bayesian algorithm in generating perfusion maps and calculations. The "External Validation" specifically assessed if the "Brain Perfusion with Bayesian algorithm (subject device) was substantially equivalent with the Brain Perfusion with SVD+ algorithm (K121213, predicate device)." This indicates an evaluation of the algorithm's output itself.

7. Type of Ground Truth Used

The "ground truth" for the external validation appears to be the expert consensus/clinical judgment of the participating "physicians" who evaluated the outputs of the Bayesian algorithm compared to the SVD+ algorithm of the predicate device. There is no mention of pathology or outcomes data being used as ground truth for this particular evaluation.

8. Sample Size for the Training Set

The document does not provide any information regarding the sample size or characteristics of the training set used for the Bayesian algorithm. As this is a 510(k) for a software update (addition of a new algorithm) to an already cleared device, the submission focuses on demonstrating the safety and effectiveness of the change relative to the predicate, rather than fully detailing the original algorithm development.

9. How Ground Truth for the Training Set Was Established

Since information on the training set itself is not provided, the method for establishing its ground truth is also not described in this document.

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November 20, 2018

Vital Images, Inc. Susan Atwood Principal Quality Engineer 5850 Opus Parkway, Suite 300 MINNETONKA, MN 55343-4414

Re: K181247

Trade/Device Name: Vitrea CT Brain Perfusion Regulation Number: 21 CFR 892.2050 Regulation Name: Picture Archiving And Communications System Regulatory Class: Class II Product Code: LLZ Dated: October 23, 2018 Received: October 24, 2018

Dear Susan Atwood:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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

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801); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/CombinationProducts/GuidanceRegulatoryInformation/ucm597488.htm); good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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 comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

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

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Indications for Use

510(k) Number (if known) K181247

Device Name Vitrea CT Brain Perfusion

Indications for Use (Describe)

Vitrea CT Brain Perfusion is a non-invasive post-processing application designed to evaluate areas of brain perfusion. The software can calculate cerebral blood flow (CBF), cerebral blood volume (CBV), local bolus timing (i.e., delay of tissue response, time to peak), and mean transit time (MTT) from dynamic CT image data acquired after the injection of contrast media. The package also allows the calculation of regions of interest and mirrored regions, as well as the visual inspection of time density curves. Vitrea CT Brain Perfusion supports the physician in visualizing the apparent blood perfusion in brain tissue affected by acute stroke. Areas of decreased perfusion, as is observed in acute cerebral infarcts, appear as areas of changed signal intensity (lower for both CBF and CBV and higher for time to peak and MTT).

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)

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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 the Submission:Vital Images, Inc. hereby submits this traditional 510(k) to provide a notification submission for proposed software changes in the already 510(k) cleared Vitrea CT Brain Perfusion software (K121213).
Submitter:Vital Images, Inc.5850 Opus Parkway, Suite 300Minnetonka, MN, 55343-4414, USA
Establishment Registration:2134213
Contact Person:Susan AtwoodPrincipal Quality EngineerPhone: 952-487-9759Fax: 952-487-9510E-mail: satwood@vitalimages.comAlternate Contact Person:Vince SwensonSr. Director of Quality and RegulatoryPhone: 952-487-9548Fax: 952-487-9510E-mail: vswenson@vitalimages.com
510(k) Type:Traditional
Summary Date:May 8, 2018
Device Trade Name:Vitrea CT Brain Perfusion
Device Common Name/ Regulatory Description:Picture Archiving and Communications System
Device Classification Name:System, Image Processing, Radiological
Regulation Number:21 CFR 892.2050
Product Code:LLZ
Regulatory Classification:Class II
Device Panel:Radiology

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Predicate Device

Predicate DeviceManufacturerFDA 510(k) Number
Vitrea CT Brain PerfusionsoftwareVital Images, Inc.5850 Opus Parkway, Suite 300Minnetonka, MN 55343USAK121213

Reference Device

Reference DeviceManufacturerFDA 510(k) Number
Olea Sphere V3.0Olea Medical93 Avenue Des Sorbiers,Zone Athelia IvLa Ciotat, FR 13600K152602

Device Description

Vitrea CT Brain Perfusion is a noninvasive post-processing software that calculates cerebral blood flow (CBF), cerebral blood volume (CBV), local bolus timing (i.e., delay of tissue response, time to peak), and mean transit time (MTT) from dynamic CT image data. It displays time density curves, perfusion characteristics in perfusion and summary maps, as well as regions of interest and mirrored regions.

Intended Use / Indications for Use

Vitrea CT Brain Perfusion is a non-invasive post-processing application designed to evaluate areas of brain perfusion. The software can calculate cerebral blood flow (CBF), cerebral blood volume (CBV), local bolus timing (i.e., delay of tissue response, time to peak), and mean transit time (MTT) from dynamic CT image data acquired after the injection of contrast media. The package also allows the calculation of regions of interest and mirrored regions, as well as the visual inspection of time density curves. Vitrea CT Brain Perfusion supports the physician in visualizing the apparent blood perfusion in brain tissue affected by acute stroke. Areas of decreased perfusion, as is observed in acute cerebral infarcts, appear as areas of changed signal intensity (lower for both CBF and CBV and higher for time to peak and MTT).

Intended for Disease / Condition / Patient Population

Vitrea CT Brain Perfusion is intended for patients with suspected compromised or abnormal cerebral blood flow.

Key Changes from last 510k clearance K121213

The following list contains the key changes since the last 510k. These changes were made to enhance user experience and performance:

  • . Addition of Bayesian algorithm.
  • Enhancements to Region-of-Interest tools (ROI) tools. ●
  • Optimized layouts to include 4-up and 6-up views. .
  • Support for loading variable time scans for multi-series studies in 2D. ●
  • Support for Jog and Helical Shuttle Thin Slice Brain Perfusion datasets from Canon ● (formerly Toshiba) Aquilion Prime Scanners.
  • . Support for Thick Slice "Jog Shuttle" from Philips Scanners (2D Perfusion).
  • . Support of 2D perfusion for thick slice irregular helical Siemens & GE scans.

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  • Increased the number of slices allowed per time series for GE & Siemens Helical Shuttle . Scans.
  • Support for DSA for Jog and Helical datasets. .
  • Enhancements to 4D thin slice to support axial and helical GE scans and helical Siemens scans.
  • . Addition of 3D Summary Map view

Regulatory Comparison

SubjectDevicePredicateDeviceReferenceDevice
CharacteristicVitrea CTBrainPerfusionwith BayesianAlgorithmVitrea CTBrainPerfusion(K121213)Olea SphereV3.0 (K152602)Comparison
Classification NameSystem, ImageProcessing,RadiologicalSystem, ImageProcessing,RadiologicalSystem, ImageProcessing,RadiologicalSame
Regulatory Number892.2050892.2050892.2050Same
Product CodeLLZLLZLLZSame
ClassificationClass IIClass IIClass IISame
Review PanelRadiologyRadiologyRadiologySame
Decision DateUnder ReviewNov. 02, 2012Mar. 03, 2016Predicate andreferencedevices arecleared.

Indications for Use Comparison with the Predicate Device

Subject DevicePredicate Device
CriteriaVitrea CT Brain Perfusionwith Bayesian AlgorithmVitrea CT Brain Perfusion(K121213)Comparison
Indicationsfor UseVitrea CT Brain Perfusion is anon-invasive post-processingapplication designed toevaluate areas of brainperfusion. The software cancalculate cerebral blood flow(CBF), cerebral blood volume(CBV), local bolus timing (i.e.,delay of tissue response, timeto peak), and mean transit time(MTT) from dynamic CT imagedata acquired after the injectionof contrast media. The packagealso allows the calculation ofregions of interest and mirroredregions, as well as the visualinspection of time densitycurves. Vitrea CT BrainVitrea CT Brain Perfusion is anon-invasive post-processingapplication designed toevaluate areas of brainperfusion. The software cancalculate cerebral blood flow(CBF), cerebral blood volume(CBV), local bolus timing (i.e.,delay of tissue response, timeto peak), and mean transit time(MTT) from dynamic CT imagedata acquired after the injectionof contrast media. The packagealso allows the calculation ofregions of interest and mirroredregions, as well as the visualinspection of time densitycurves. Vitrea CT BrainSame

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CriteriaSubject DevicePredicate DeviceComparison
Vitrea CT Brain Perfusionwith Bayesian AlgorithmVitrea CT Brain Perfusion(K121213)
Perfusion supports thephysician in visualizing theapparent blood perfusion inbrain tissue affected by acutestroke. Areas of decreasedperfusion, as is observed inacute cerebral infarcts, appearas areas of changed signalintensity (lower for both CBFand CBV and higher for time topeak and MTT).Perfusion supports thephysician in visualizing theapparent blood perfusion inbrain tissue affected by acutestroke. Areas of decreasedperfusion, as is observed inacute cerebral infarcts, appearas areas of changed signalintensity (lower for both CBFand CBV and higher for time topeak and MTT).
IntendedUsersQualified healthcareprofessionals including, but notrestricted to, radiologists, non-radiology specialists,physicians and technologists.Qualified healthcareprofessionals including, but notrestricted to, radiologists, non-radiology specialists,physicians and technologists.Same
PatientPopulationPatients with suspectedcompromised or abnormalcerebral blood flow.Patients with suspectedcompromised or abnormalcerebral blood flow.Same
ModalitySupportCTCTSame

Similarities in Technology with the Predicate Device

Subject DevicePredicateDevice
Software FunctionalityVitrea CT BrainPerfusion withBayesianAlgorithmVitrea CT BrainPerfusion(K121213)Comparison
Quantitative brain perfusion mapsfor:• Regional cerebral bloodvolume (rCBV)• Regional cerebral bloodflow (rCBV)• Mean transit time (MTT)• Time to peak of tissue(TTP)• Delay of tissue response(Delay)YesYesSame
Display:• Region of interest (ROI)• Mirrored regions• Time density curvesYesYesSame
Subject DevicePredicateDevice
Software FunctionalityVitrea CT BrainPerfusion withBayesianAlgorithmVitrea CT BrainPerfusion(K121213)Comparison
Display of Perfusion Maps in:MPR orientations•2D•3DYesYesSame
4D-DSA (digital subtractionangiography) view for visualizingflow of contrast through the vesselsYesYesSame
Perfusion maps in MPR orientationsand 2DYesYesSame
Automatic motion correction andcurve fittingYesYesSame
Region of interest (ROI) templatesYesYesSame
Midline identification and displayYesYesSame
Manual and automatic detection ofartery and vein locationsYesYesSame
Automatic calculation ofquantitative brain perfusionresultsYesYesSame
Window leveling, edit mid-planeline, display mirrored ROIs,snapshots, time-series batch,movies for physician reportingYesYesSame
Report generation for the BrainPerfusion patient studyYesYesSame
Perfusion measurement averagesfor multiple ROIs with ability tomirror an ROI from one hemisphereto the otherYesYesSame
Window leveling, edit mid-planeline, display mirrored ROIs,snapshots, time-series batch,movies for physician reportingYesYesSame
Color coded Summary mapsYesYesSame
Subject DevicePredicateDevice
SoftwareFunctionalityVitrea CT BrainPerfusion withBayesianAlgorithmVitrea CTBrainPerfusion(K121213)Comparison
Bayesian PerfusionAlgorithmYesNoSubject device provides userwith choice to use either theBayesian algorithm or SVD+algorithm.Predicate device can use theSVD+ algorithm.Note: The added Bayesianalgorithm in the subject device issimilar to the Bayesian algorithmin the reference device, OleaSphere 3.0, which was clearedby the FDA under K152602.Therefore, this added algorithmdoes not raise differentquestions of safety andeffectiveness.

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Differences in Technology with the Predicate Device

Similarities in Technology with the Reference Device

Subject DeviceReferenceDevice
Software FunctionalityVitrea CT BrainPerfusion withBayesianAlgorithmOlea SphereV3.0 (K152602)Comparison
Bayesian Algorithm:The Bayesian estimation of thehemodynamical parametersintegrates a model-basedapproach especially robust toimage noise and fast analyticalintegration techniques to computethe posterior probabilities of theestimated blood flow, delay, MTTand time concentration curves(residue functions).YesYesSame
Motion correctionYesYesSame
Automatic Arterial Input functionand Vein Output functionYesYesSame

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Subject DeviceReferenceDevice
Software FunctionalityVitrea CT BrainPerfusion withBayesianAlgorithmOlea SphereV3.0 (K152602)Comparison
Automatic vessel removalYesYesSame
Automatic Brain Midline detectionYesYesSame
Noise reduction is applied beforethe Bayesian computation.YesYesSame
Model based Bayesian estimationof perfusion parameters.YesYesSame
Delay insensitive method.YesYesSame

Summary of Non-Clinical Tests

The changes to the Vitrea CT Brain Perfusion software were designed, developed, and tested according to written procedures that included risk management. Software verification 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 Vitrea CT Brain Perfusion software:

  • . Risk Management
  • Requirements Reviews ●
  • Code Designs ●
  • Code Development Testing ●
  • Code Reviews ●
  • Design Reviews ●
  • Verification of the software
  • . Validation of the software

Risk Management

Each risk pertaining to the modifications to the Vitrea CT Brain Perfusion software has 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 "Improbable." All risks for these modifications were collectively reviewed to determine if the benefits outweigh the risk. Based on Post Market information and because of the risk control measures included in these modifications, it is believed that the risk for these modifications as a whole are extremely low. Considering all risks against the benefits, it has been assessed that the benefits do outweigh the risks for these modifications.

009 510(k) Summary

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During the design review, the following conclusions were reached:

  • The medical benefits of the device outweigh the residual risk for each individual risk and ● all risks together
  • . All risks have been reduced as low as possible
  • . The overall residual risk for the software product is deemed acceptable

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, requirements and risk mitigations. Verification testing confirmed the software functions according to its requirements and all risk mitigations are functioning properly.

Validation

The software validation team's primary qoal was to assure that 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 properly to conform to the intended use.

Alqorithm Testing

Algorithm testing was performed to validate the proper function of the Bayesian algorithms within Vitrea CT Brain Perfusion. The Vitrea CT Brain Perfusion Bavesian algorithm has passed all the verification and validation and is therefore considered validated and acceptable.

External Validation

During the external validation of the Vitrea CT Brain Perfusion software, physicians evaluated if the Brain Perfusion with Bayesian algorithm (subject device) was substantially equivalent with the Brain Perfusion with SVD+ algorithm (K121213, predicate device). Based on the scores provided by the physicians, Vital concluded the Brain Perfusion with Bayesian algorithm is as safe and effective as the already cleared Brain Perfusion with SVD+ algorithm and fulfills its intended use.

Summary of Clinical Tests

The subject of this 510(k) notification, Vitrea CT Brain Perfusion software, did not require clinical studies to support safety and effectiveness of the software.

Cyber and Information Security

The Vitrea CT Brain Perfusion software follows internal documentation which includes information based on the FDA Guidance: Content of Premarket Submissions for Management of Cybersecurity in Medical Devices.

Internal documentation covers the following:

    1. Hazard analysis, mitigations, and design considerations pertaining to intentional and unintentional cybersecurity risks associated with the device, including:
    • A specific list of all cybersecurity risks that were considered in the design of the . device;

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  • . A specific list and justification for all cybersecurity controls that were established for the device.
  • A traceability matrix that links the actual cybersecurity controls to the cybersecurity risks 2. that were considered;
    1. A summary describing the plan for providing validated software updates and patches as needed throughout the lifecycle of the medical device to continue to assure its safety and effectiveness. The FDA typically will not need to review or approve medical device software changes made solely to strengthen cybersecurity.
  • A summary describing controls that are in place to assure that the medical device 4. software will maintain its integrity (e.g. remain free of malware) from the point of origin to the point at which that device leaves the control of the manufacturer; and
    1. Device instructions for use and product specifications related to recommended cybersecurity controls appropriate for the intended use environment (e.g. anti-virus software, use of firewall).

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.StandardsOrganizationStandard TitleVersionDate
PS 3.1- 3.20 (2016)(RecognitionNumber 12-300)NEMADigital Imaging andCommunications in Medicine(DICOM) Set (Radiology)306/27/2016
ISO 14971:2007/(R)2010(RecognitionNumber 5-70)AAMI / ANSI/ ISOMedical Devices -Applications of RiskManagement to MedicalDevices200706/27/2016
IEC 62304:2006(RecognitionNumber 13-32)AAMI / ANSI/ IECMedical Device Software -Software Life CycleProcesses (Software /Informatics)200608/20/2012

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

Substantial Equivalence Analysis Conclusion

Vital Images, Inc. believes the Vitrea CT Brain Perfusion software with Bayesian algorithm has a similar intended use, indications for use, principle of operation, and technological characteristics as the legally marketed, predicate device Vitrea CT Brain Perfusion with SVD+ algorithm (K121213). In addition, the Bayesian perfusion algorithm added to the Vitrea CT Brain Perfusion software is similar to the Bayesian perfusion algorithm in the reference device, Olea Sphere V3.0, which was cleared by the FDA under K152602.

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Furthermore, the verification and validation testing performed demonstrates the subject device is as safe and effective as the predicate device and does not raise any different questions of safety and effectiveness. Therefore, Vital believes the enhancements in the Vitrea CT Brain Perfusion software do not alter the fundamental scientific technology, safety or intended use of the device.

Each change was evaluated for the impact to the safety and effectiveness of the software. It was concluded that the changes 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 and validation tests demonstrate the safety and efficacy of the subject device. Based on the comparison information provided above, Vital Images, Inc. 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).