K Number
K181983
Date Cleared
2018-08-17

(23 days)

Product Code
Regulation Number
892.1750
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

PreXion 3D Excelsior is intended to produce two dimensional digital panoramic and cephalometric images, and three dimensional digital X-ray images of the dental (oral), maxillofacial, and ENT (Ear, Nose and Throat) region at the direction of healthcare professionals as diagnostic support for adult and pediatric patients. Cephalometric imaging also includes the hand wrist to obtain carpus images for growth and maturity assessment.

Device Description

PreXion 3D Excelsior consists of a scanner, which is used for generating X-ray and detecting image data, and a Console, which is used for operating the scanner and managing the data. The scan data acquired by the scanner will be transferred to the Console. PreXion3D Excelsior Image Analysis System will then perform the image analysis (2D/3D) or image edition (creating cross-section diagram, etc.), and output the image to a printer. During scanning, X-rays are generated from the x-ray tube head mounted in the arm of the scanner and the x-rays passing through a patient are then detected by the flat panel detector of the scanner under the control of the firmware inside and the console software installed on the qualified Computer. The detected x-ray absorption data is processed by the console software to reconstruct the diagnostic images. The PreXion3D Excelsior has three operation modes, CT scan, Panoramic scan and Cephalometric exposure.

AI/ML Overview

The provided text is a 510(k) Summary for the PreXion 3D Excelsior device. It focuses on demonstrating substantial equivalence to a predicate device rather than presenting detailed acceptance criteria and a study proving device performance against those criteria in the context of an AI-driven diagnostic aid.

Specifically, the document discusses:

  • Device Description: The PreXion 3D Excelsior is a dental cone-beam computed tomography (CT) device.
  • Modifications from Predicate: The subject device adds a "CT-panoramic" mode (reconstructing panoramic images from CT raw data) and an "Airway measurement function" (calculates volume and cross-section area of airways).
  • Non-Clinical Performance Data: Conformance to various harmonized standards (e.g., IEC 60601-1, ISO 14971) and specific testing for 3D imaging performance (MTF for three image orientations).
  • Software Quality Activities: Compliance with software moderate level concern based on risk management and usability evaluation, including bench tests and user evaluations.
  • Conclusion: The device is substantially equivalent to the predicate device.

However, the document does NOT provide the requested information regarding acceptance criteria related to AI/Machine Learning performance (e.g., sensitivity, specificity, AUC) or a clinical study proving AI-driven diagnostic aid performance. The "Airway measurement function" is described as an additional supplemental function, but no performance metrics for this automated measurement function are presented, nor is it explicitly stated to be an AI-driven diagnostic aid in the sense of pattern recognition or disease detection.

Therefore, I cannot extract the information required to formulate the table and answer the detailed questions about acceptance criteria for an AI device and the study proving it meets those criteria. The provided submission is for a medical imaging device (CT scanner) and its software, not an AI diagnostic software that requires assessment of diagnostic accuracy.

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Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

August 17, 2018

PreXion Corporation % Mr. Katsumi Hayashi Director, Quality Assurance and Regulatory Division 1-14-1 Kandasuda-cho, Chiyoda-ku, Tokyo 101-0041 JAPAN

Re: K181983

Trade/Device Name: PreXion 3D Excelsior Regulation Number: 21 CFR 892.1750 Regulation Name: Computed tomography x-ray system Regulatory Class: II Product Code: OAS Dated: July 23, 2018 Received: July 25, 2018

Dear Mr. Hayashi:

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/cfpmp/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

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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 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 (QS) 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.

Hsl 2. Nils

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

Enclosure

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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

Form Approved: OMB No. 0910-0120 Expiration Date: 06/30/2020 See PRA Statement below.

510(k) Number (if known)

K181983

Device Name PreXion 3D Excelsior

Indications for Use (Describe)

PreXion3D Excelsior is intended to produce two dimensional digital panoramic and cephalometric images, and three dimensional digital X-ray images of the dental (oral), maxillofacial, and ENT (Ear, Nose and Throat) region at the direction of healthcare professionals as diagnostic support for adult and pediatric patients. Cephalometric imaging also includes the hand wrist to obtain carpus images for growth and maturity assessment.

(Note: We have added technical term "dental(oral)" to clarify Indications for Use. We believe that is same definition of Indications for Use between predicate device and subject device.)

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.

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."

FORM FDA 3881 (7/17)

PSC Publishing Services (301) 443-6740 DF

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510(k) Summary

This summary of 510(k) safety and effectiveness information is submitted in accordance with the requirements of the Safe Medical Devices Act of 1990 and 21 CFR 807.92.

510(k) Number:

6.1 Applicant Information

Date Prepared:July 23th, 2018
Company Name and Address:PreXion Corporation1-14-1 Kandasuda-cho, Chiyoda-kuTokyo, 101-0041Japan
Contact Person:Mr. Katsumi HayashiDirector, Quality Assurance and Regulatory DivisionPhone: +81-3-5297-7551FAX: +81-3-5297-7552Email: hayashi@prexion.co.jp

6.2 Device Information

Type of 510(k) SubmissionSpecial
Device Type:Dental Cone-beam Computed Tomography
Regulation Description:Computed Tomography X-Ray System
Review Panel:Radiology
Regulation Number:21 CFR 892.1750
Product Code:OAS
Device Class:II
Device Name:PreXion3D Excelsior

6.3 Predicate Device Information

The legally marketed devices to which substantial equivalence is being claimed are:

510(k) Number:K173878
Applicant:PreXion Corporation
Device Name:PreXion 3D Excelsior
Regulation Number:21 CFR 892.1750
Product Code:OAS
Device Class:II

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6.4 Device Description

PreXion 3D Excelsior consists of a scanner, which is used for generating X-ray and detecting image data, and a Console, which is used for operating the scanner and managing the data. The scan data acquired by the scanner will be transferred to the Console. PreXion3D Excelsior Image Analysis System will then perform the image analysis (2D/3D) or image edition (creating cross-section diagram, etc.), and output the image to a printer.

During scanning, X-rays are generated from the x-ray tube head mounted in the arm of the scanner and the x-rays passing through a patient are then detected by the flat panel detector of the scanner under the control of the firmware inside and the console software installed on the qualified Computer. The detected x-ray absorption data is processed by the console software to reconstruct the diagnostic images. The PreXion3D Excelsior has three operation modes, CT scan, Panoramic scan and Cephalometric exposure.

Summary of predicate device modifications

Predicate device has Panoramic scan mode, but Subject device is added CT-panoramic mode besides Panoramic scan mode. CT-panoramic mode is a function for CT imaging in which a panoramic image is produced by performing panoramic image reconstruction using the raw-data from CT scan. The user can observe CT image and CT-panoramic image at the same time.

Furthermore, Subject device is added Airway measurement function, which gives inner wall of airway distinquish color, and it calculates volume and cross section area.

6.5 Intended Use/Indications for Use

PreXion 3D Excelsior is intended to produce two dimensional digital panoramic and cephalometric images, and three dimensional digital x-ray images of the dental(oral), maxillofacial, and ENT (Ear, Nose and Throat) region at the direction of healthcare professionals as diagnostic support for adult and pediatric patients.

Cephalometric imaging also includes the hand and wrist to obtain carpus images for growth and maturity assessment.

6.6 Comparison to the Predicate Device

The subject device compares to the legally marketed devices as follows:

DevicePredicate DeviceModified Device
PreXion3D Excelsior (K17387)PreXion3D Excelsior
IntendedUse/Indications for UsePreXion3D Excelsior is intendedto produce two dimensionaldigital panoramic andcephalometric images, and threedimensional digital x-ray imagesof the maxillofacial, and ENT(Ear, Nose and Throat) region atthe direction of healthcareprofessionals as diagnosticsupport for adult and pediatricpatients.PreXion3D Excelsior is intended toproduce two dimensional digitalpanoramic and cephalometricimages, and three dimensional digitalx-ray images of the dental(oral),maxillofacial, and ENT (Ear, Noseand Throat) region at the direction ofhealthcare professionals asdiagnostic support for adult andpediatric patients.Cephalometric imaging also includes
Cephalometric imaging alsoincludes the hand and wrist toobtain carpus images for growthand maturity assessmentthe hand and wrist to obtain carpusimages for growth and maturityassessment
X-rayGenerationDeviceTubeVoltage60-110KV60-110KV
PulseExposurefunctionYesYes
TubeCurrent1-6mA1-6mA
FocalSpot Size0.3mm0.3mm
X-rayImageCapturingDeviceDetector125μm x 125μm, 125μmx 250μm (CT)125μm x 125μm (Panoramic)140 μm x 140μm (Ceph)125μm x 125μm, 125μmx 250μm (CT)125μm x 125μm (Panoramic)140 μm x 140μm (Ceph)
PixelNumber1280x1024 (CT)128x1280 (Panoramic)2112x1754 (Cephalometric)1280x1024 (CT)128x1280 (Panoramic)2112x1754 (Cephalometric)
Size ofAreaReceivingX-ray160mm x 128mm (CT)160mm x 12.5mm (Panoramic)295.68 x 245.56mm (Ceph)160mm x 128mm (CT)160mm x 12.5mm (Panoramic)295.68 x 245.56mm (Ceph)
Number ofBits16bits (CT, Panorama)14bits (Ceph)16bits (CT, Panorama)14bits (Ceph)
ScannerSID/SOD700mm/ 470mm (CT,Panoramic)1735mm / 1500mm (Ceph)700mm/ 470mm (CT, Panoramic)1735mm / 1500mm (Ceph)
Dimension(WxDxH)930 mm x 1230 mm x2220 mm (CT, Panoramic)1816 mm x 1230 mm x2220 mm (with Ceph)930 mm x 1230 mm x2220 mm (CT, Panoramic)1816 mm x 1230 mm x2220 mm (with Ceph)
Weight165 kg (CT, Panoramic)200kg (Ceph)165 kg (CT, Panoramic)200kg (Ceph)
Imaging ModeCT scan, Panoramic scan,Cephalometric radiographyCT scan, Panoramic scan,Cephalometric radiography
Panoramic ScanPerformance (ScanTime)8-16sec8-16sec
CephalometricRadiography (ScanTime)0.5-0.8 sec0.5-0.8 sec
Viewer Software (ImageAnalysis SystemSoftware)Display High-resolution 2D and3D Images FunctionDisplay High-resolution 2D and 3DImages Function
Image Processing FunctionImage Processing Function
Image Operation FunctionImage Operation FunctionIncluding Airway measurement
Output FunctionOutput Function
Console SoftwareSystem SettingsCT ScanCT Scanincluding CT-Panoramic mode

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Modified device is added CT-Panoramic mode and Airway measurement function.

CT-panoramic mode is a function for CT imaging in which a panoramic image is produced by performing panoramic image reconstruction using the raw-data from CT scan. The user can observe CT image and CT-panoramic image at the same time.

Airway measurement function gives inner wall of airway distinguish color, and it calculates volume and cross section area.

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6.7 Non-Clinical Performance Data

The subject device has demonstrated conformance to non-clinical performance requirements through evaluation and testing in accordance with the following harmonized standards:

ANSI/AAMI ES60601-1 IEC 60601-1-2 IEC 60601-1-3 IEC 60601-1-6 IEC 62366 IEC 62304 IEC 60601-2-63 IEC 61223-3-4 IEC 61223-3-5 IEC 60825-1 ISO 14971 NEMA PS 3.1 - 3.20 ISO 10993-1 ISO 10993-5 ISO 10993-10

In addition to the conformance with the above recognized standards, the following testing and nonclinical considerations were preformed:

  • . Testing for 3D imaging performance to assess MTF for three image orientations (x, y, z) for the applicable 3D modes of device operation.
  • . Non-clinical considerations according to FDA Guidance "Guidance for the Submission of 510(k)'s for Solid State X-ray Imaging Devices"

Results of all non-clinical testing and non-clinical considerations support the safety and effectiveness of the subject device.

6.8 Brief description of software quality activities

Software quality activities for subject device is according to above standards. Based on risk management and usability evaluation, the software is verified and validated including bench tests and user evaluations. Via these processes, software quality activities for subject device comply with software moderate level concern.

6.9 Conclusions

The subject device clarified the Intended Use/Indications for Use, but both Intended Use/Indications for Use are same meaning between predicate and subject devices. In Viewer Software, the subject device has a different function from those of the predicate device. But, this is just additional supplemental function of the image processing functions. In Console Software, the subject device has different function from those of the predicate device. But, this is just additional supplemental function of the CT Scan mode.

Based on the above information and all data provided in this submission, the comparison of Intended Uses/Indications for Use and technological characteristics that the subject device is substantially equivalent to the predicate device identified in this submission.

§ 892.1750 Computed tomography x-ray system.

(a)
Identification. A computed tomography x-ray system is a diagnostic x-ray system intended to produce cross-sectional images of the body by computer reconstruction of x-ray transmission data from the same axial plane taken at different angles. This generic type of device may include signal analysis and display equipment, patient and equipment supports, component parts, and accessories.(b)
Classification. Class II.