K Number
K182951
Device Name
Pristina Serena 3D
Manufacturer
Date Cleared
2019-01-18

(87 days)

Product Code
Regulation Number
892.1715
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Pristina Serena 3D option provides the three-dimensional location of target lesions, using information obtained from Digital Breast Tomosynthesis (DBT) images. This information provides guidance for a variety of minimally invasive or interventional procedures in the breast such as: vacuum assisted biopsy, core biopsy, pre-surgical localization (e.q. hookwire), and fine needle aspirations (FNA).
Device Description
Pristina Serena 3D is DBT Biopsy System for Senographe Pristina. It is an additional option that builds upon the Pristina Serena device (GE Healthcare Stereotaxy biopsy option for Senographe Pristina platform). Pristina Serena was cleared on May 14, 2018 (K173576). Pristina Serena 3D enables biopsy medical application to be done using Digital Breast Tomosynthesis (DBT) images. The Pristina Serena 3D add-on includes the following items: Software: A new software version for the Senographe Pristina platform which includes software to manage the Pristina Serena 3D option. Labeling for the Biopsy DBT (3D) Medical application. Pristina Serena 3D option is compatible with previously installed Senographe Pristina systems. Pristina Serena 3D does not require any hardware modification on the Senographe Pristina platform. The hardware that was cleared on Pristina Serena 3D (K173576) was also not modified.
More Information

Senographe Pristina 3D (P130020/S002 and S003), Hologic’s Affirm Breast Biopsy Guidance System (K122836) and Affirm Lateral Arm Upright Biopsy Accessory (K161575)

No
The summary describes a software add-on for a DBT system that provides 3D lesion location guidance based on existing DBT images. There is no mention of AI, ML, or any learning-based algorithms for image analysis or guidance. The focus is on utilizing the 3D information from DBT for procedural guidance.

No
The device provides guidance for minimally invasive procedures (e.g., biopsy, localization) but does not directly treat a disease or condition itself.

No

Explanation: The device is described as providing guidance for minimally invasive or interventional procedures like biopsy and localization, using information from DBT images. It is an "additional option" that enables "biopsy medical application." This indicates it is an interventional guidance tool, not a diagnostic device that identifies or characterizes diseases.

No

The device is described as an "additional option" and "add-on" to the Senographe Pristina platform, which is a hardware device (DBT Biopsy System). While the add-on itself is primarily software, it functions as part of a larger hardware system and relies on that hardware for image acquisition and potentially other functions. The description explicitly states it builds upon the existing Pristina Serena device (K173576), which is a hardware system.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are tests performed on samples such as blood, urine, or tissue that have been taken from the human body to detect diseases, conditions, or infections.
  • Device Function: The Pristina Serena 3D option is a software add-on for a medical imaging system (Senographe Pristina) that uses Digital Breast Tomosynthesis (DBT) images to provide guidance for interventional procedures in the breast. It processes images obtained from the patient's body, not samples taken from the patient's body.
  • Intended Use: The intended use is to provide guidance for procedures like biopsies and localizations, which are performed on the patient, not on samples in a lab.
  • Input: The input is DBT images, which are generated by the imaging system, not biological samples.

The device is clearly a medical device used for image-guided procedures, falling under the category of imaging and interventional systems, not in vitro diagnostics.

N/A

Intended Use / Indications for Use

The Pristina Serena 3D option provides the three-dimensional location of target lesions, using information obtained from Digital Breast Tomosynthesis (DBT) images. This information provides guidance for a variety of minimally invasive or interventional procedures in the breast such as: vacuum assisted biopsy, core biopsy, pre-surgical localization (e.q. hookwire), and fine needle aspirations (FNA).

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

MUE

Device Description

Pristina Serena 3D is DBT Biopsy System for Senographe Pristina. It is an additional option that builds upon the Pristina Serena device (GE Healthcare Stereotaxy biopsy option for Senographe Pristina platform). Pristina Serena was cleared on May 14, 2018 (K173576).

Pristina Serena 3D enables biopsy medical application to be done using Digital Breast Tomosynthesis (DBT) images.

The Pristina Serena 3D add-on includes the following items: Software: A new software version for the Senographe Pristina platform which includes software to manage the Pristina Serena 3D option. Labeling for the Biopsy DBT (3D) Medical application. Pristina Serena 3D option is compatible with previously installed Senographe Pristina systems. Pristina Serena 3D does not require any hardware modification on the Senographe Pristina platform. The hardware that was cleared on Pristina Serena 3D (K173576) was also not modified.

Mentions image processing

In regards with Image Quality / Image processing, the Proposed device and the reference device Senographe Pristina 3D (P130020/S002 and S003) both use the same DBT image chain and DBT reconstruction.

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Digital Breast Tomosynthesis (DBT) images

Anatomical Site

breast

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

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 safety and performance of the Pristina Serena 3D option was demonstrated through full verification testing and additional engineering bench performance testing such as:

  • Non-Clinical Data - Image Quality and Dose test that demonstrates that images acquired with Pristina Serena 3D are of same quality as images acquired with Senographe Pristina at similar dose levels.
  • Pristina Serena 3D Design and Usability Validation Report which contains evidence of validation of claims and performance bench testing.

These tests were performed to provide the requisite data to substantiate performance, claims, and ultimately substantial equivalence. The testing demonstrated that Pristina Serena 3D performs according to specifications and functions as intended.

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.

Pristina Serena (K173576)

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.

Senographe Pristina 3D (P130020/S002 and S003), Hologic’s Affirm Breast Biopsy Guidance System (K122836) and Affirm Lateral Arm Upright Biopsy Accessory (K161575)

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

§ 892.1715 Full-field digital mammography system.

(a)
Identification. A full-field digital mammography system is a device intended to produce planar digital x-ray images of the entire breast. This generic type of device may include digital mammography acquisition software, full-field digital image receptor, acquisition workstation, automatic exposure control, image processing and reconstruction programs, patient and equipment supports, component parts, and accessories.(b)
Classification. Class II (special controls). The special control for the device is FDA's guidance document entitled “Class II Special Controls Guidance Document: Full-Field Digital Mammography System.”See § 892.1(e) for the availability of this guidance document.

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Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA) along with the Department of Health & Human Services. The FDA logo features a blue square with the letters 'FDA' in white, followed by the words 'U.S. FOOD & DRUG ADMINISTRATION' in blue. To the left of the FDA logo is the Department of Health & Human Services seal, which includes an emblem with a caduceus-like symbol and the text 'DEPARTMENT OF HEALTH & HUMAN SERVICES-USA' arranged around it.

January 18, 2019

GE Healthcare Nicole Landreville Regulatory Affairs Manager 283 rue de la Miniere BUC, 78530 FRANCE

Re: K182951

Trade/Device Name: Pristina Serena 3D Regulation Number: 21 CFR 892.1715 Regulation Name: Full-Field Digital Mammography System Regulatory Class: Class II Product Code: MUE Dated: October 22, 2018 Received: October 23, 2018

Dear Nicole Landreville:

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 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 801); medical

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device reporting (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 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)

K182951

Device Name Pristina Serena 3D

Indications for Use (Describe)

The Pristina Serena 3D option provides the three-dimensional location of target lesions, using information obtained from Digital Breast Tomosynthesis (DBT) images. This information provides guidance for a variety of minimally invasive or interventional procedures in the breast such as: vacuum assisted biopsy, core biopsy, pre-surgical localization (e.q. hookwire), and fine needle aspirations (FNA).

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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510(k) Summary

In accordance with 21 CFR 807.92 the following summary of information is provided:

Date:January 18, 2018
Submitter:GE Healthcare
GE Medical Systems SCS
283 RUE DE LA MINIERE
78530 BUC – FRANCE
Primary Contact Person:Nicole Landreville, Eng, RAC, FRAPS
Regulatory Affairs Manager
380 Hampton Heath road
Burlington, ON, Canada
L7L 4R2
Phone : 289-208-2365
Email : nicole.landreville@ge.com
Secondary Contact Person:Gregory Pessato,
Regulatory Affairs Program Manager,
GE Medical Systems SCS
283 RUE DE LA MINIERE
78530 BUC – FRANCE
Phone : + 33 1 30 70 93 16
Email : gregorypessato@ge.com
Device Trade Name:Pristina Serena 3D
Common/Usual Name:Stereotaxy biopsy guidance application for a Digital Breast Tomosynthesis (DBT) Mammography System Biopsy System for Senographe Pristina
Classification Names:21 CFR 892.1715, Class II
Product Code:MUE
Predicate Device:Pristina Serena (K173576)
Reference devices:Senographe Pristina 3D (P130020/S002 and S003) Hologic's Affirm Breast Biopsy Guidance System (K122836) and Affirm Lateral Arm Upright Biopsy Accessory (K161575)
Device Description:Pristina Serena 3D is DBT Biopsy System for Senographe Pristina. It is an additional option that builds upon the Pristina Serena device (GE Healthcare Stereotaxy biopsy option for Senographe Pristina platform). Pristina Serena was cleared on May 14, 2018 (K173576).

Pristina Serena 3D enables biopsy medical application to be done using Digital Breast Tomosynthesis (DBT) images.

The Pristina Serena 3D add-on includes the following items: Software: A new software version for the Senographe Pristina platform which includes software to manage the Pristina Serena 3D option. Labeling for the Biopsy DBT (3D) Medical application. Pristina Serena 3D option is compatible with previously installed Senographe Pristina systems. Pristina Serena 3D does not require any hardware modification on the Senographe Pristina platform. The hardware that was cleared on Pristina Serena 3D (K173576) was also not modified. |
| Intended Use: | Pristina Serena 3D is an optional accessory of Senographe Pristina intended to provide accurate location of lesions in the breast in three dimensions. |
| Indications for Use | The Pristina Serena 3D option provides the three-dimensional location of target lesions, using information obtained from Digital Breast Tomosynthesis (DBT) images. This information provides guidance for a variety of minimally invasive or interventional procedures in the breast such as: vacuum assisted biopsy, core biopsy, pre-surgical localization (e.g. hookwire), and fine needle aspirations (ENA) |
| Technology: | Pristina Serena 3D uses the DBT images to determine the three-dimensional (3D) location (X, Y and Z coordinates) of an object of interest in the breast (such as a suspicious lesion). The X and Y coordinates are determined directly from the displayed plane as it is parallel to the detector while the Z coordinate is determined with the height of this same plane in the whole reconstructed volume.
The target lesion 3D coordinates information, together with the complete geometry of the device, are used to compute the required position of a biopsy device holder that will allow intervention in the breast at the exact target position (biopsy of sample tissue or placement of a hook wire for guidance of surgical interventions). With Pristina Serena 3D, the positioning of the biopsy device holder is motorized and takes into account the geometry of the biopsy needles, so when the biopsy device holder is in place, the user introduces the needle in the breast until reaching the mechanical stop of the biopsy device holder. As the biopsy needle is fixed on and guided by the biopsy device holder (not handed), the needle tip (or notch) will then be at the target lesion 3D coordinates.
As it was for Pristina Serena option, the Pristina Serena 3D allows two different needle approaches for Biopsy: vertical and horizontal (left or right). In vertical approach, the needle is introduced from the “top” of the compressed breast. In horizontal approach, the needle is introduced from the side of the compressed breast. Depending on patient morphology and location of the lesion to be biopsied in the breast, a radiologist might choose an approach or the other. Usually an effort is made to use an approach that would limit the distance crossed by the needle in the breast to reach the target location.
Since Pristina Serena 3D option uses the Image chain of the Senographe Pristina platform, the image quality of images during the biopsy procedure is equivalent to that of standard screening/diagnostic images of Senographe Pristina 3D.
Regarding dose management, with Pristina Serena 3D, a single DBT acquisition allows for both confirming appropriate breast positioning and for lesion targeting (as opposed to a Stereotaxy procedure that requires three X-ray acquisitions: one scout image |
| | plus a stereotaxic pair). This translates into dose reduction to
patient. |
| Comparison with
Reference Devices | In regards with Image Quality / Image processing, the Proposed
device and the reference device Senographe Pristina 3D
(P130020/S002 and S003) both use the same DBT image chain
and DBT reconstruction.
Regarding dose management, the Proposed Pristina Serena 3D
uses a single AOP mode available when acquiring biopsy
images. This AOP mode provides the same parameters as the
Senographe Pristina 3D AOP mode called "STD+"
(P130020/S003 3D STD+ on Senographe Pristina 3D
submission). |
| | The Proposed Pristina Serena 3D and the reference device
Hologic's Affirm Breast Biopsy Guidance System (K122836)
and Affirm Lateral Arm Upright Biopsy Accessory (K161575),
both DBT features use tomosynthesis images to provide accurate
location of lesions in the breast in three dimensions.
Both 3D localization features calculate a three dimensional
location for percutaneous placement for biopsy, pre-surgical
localization or treatment devices. |
| | It is important to note also that the Senographe Pristina with
Pristina Serena and Pristina Serena 3D offer both the 2D
stereotactic or 3D tomosynthesis image acquisition.
Both DBT features use the same method of use, they both use a
Dedicated Breast Biopsy Positioner, same mechanism of action
and same stated accuracy. They have the same Stereotactic
Angle (±15°) but they differ slightly in DBT Tomographic angle
15° total (± 7.5 degrees) for Hologics reference device versus
25° total (± 12.5°) (which has no impact on the target coordinate
computation for biopsy applications). |
| Determination of
Substantial Equivalence: | The device has successfully completed required design control
testing per GE Healthcare's quality management system. No
unexpected test results were obtained. The Pristina Serena 3D
option was designed and will be manufactured under the Quality
System Regulations of 21CFR 820 and ISO 13485. The
following quality assurance measures were applied to the
development of the system: |
| | Risk Analysis

Design Reviews
• |
| • | Software Development Lifecycle |
| • | Testing on unit level (Module verification) |
| • | Integration testing (System verification) |
| • | Performance testing (Verification) |
| • | Safety testing (Verification) |
| • | Simulated use testing (Validation) |
| The safety and performance of the Pristina Serena 3D option
was demonstrated through full verification testing and additional
engineering bench performance testing such as:

  • Non-Clinical Data - Image Quality and Dose test that
    demonstrates that images acquired with Pristina
    Serena 3D are of same quality as images acquired
    with Senographe Pristina at similar dose levels.
  • Pristina Serena 3D Design and Usability Validation
    Report which contains evidence of validation of
    claims and performance bench testing | |
    | These tests were performed to provide the requisite data to
    substantiate performance, claims, and ultimately substantial
    equivalence. The testing demonstrated that Pristina Serena 3D
    performs according to specifications and functions as intended. | |
    | Conclusion: | Based on: conformance to standards; development under GE
    Healthcare's quality management system and design controls;
    successful verification/validation testing; utilization of the very
    well established stereotactic imaging principles and additional
    bench performance testing, GE Healthcare believes that the
    optional Pristina Serena 3D option is substantially equivalent to
    its predicate device Pristina Serena (K173576) and reference
    devices: Senographe Pristina 3D (P130020/S002 and S003) and
    Hologic's Affirm Breast Biopsy Guidance System (K122836)
    and Affirm Lateral Arm Upright Biopsy Accessory (K161575).

Therefore, GE Healthcare concludes that Pristina Serena 3D is
as safe and as effective as the Predicate device for its intended
use. |

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