K Number
K192686
Device Name
Revolution Maxima, Revolution Ace
Date Cleared
2019-10-24

(28 days)

Product Code
Regulation Number
892.1750
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The system is intended to produce cross-sectional images of the body by computer reconstruction of x-ray transmission data taken at different angles and planes, including Axial, Cine, Helical (Volumetric), Cardiac, and Gated acquisitions. These images may be obtained either with or without contrast. This device may include signal analysis and display equipment, patient and equipment supports, components and accessories. This device may include data and image processing to produce images in a variety of trans-axial and reformatted planes. Further the images can be post processed to produce additional imaging planes or analysis results. The system is indicated for head, whole body, cardiac and vascular X-ray Computed Tomography applications in patients of all ages. The device output is a valuable medical tool for the diagnosis of disease, trauma, or abnormality and for planning, guiding, and monitoring therapy.
Device Description
The Revolution Maxima CT system is composed of a gantry, patient table, operator console, host computer, and power distribution unit (PDU), and interconnecting cables. The system also includes image acquisition and reconstruction hardware/software, general system software, accompanying documents, and associated accessories, interconnections. The Revolution Maxima system is an evolutionary configuration of the predicate Optima CT660 CT system (K131576). All of the hardware functionality is identical to the predicate, however, some hardware changes have been made that did not change the system's performance specifications such as the new liquid metal bearing tube for improved tube life and reliability, the upgraded DAS and detector to improve the manufacturability and lower electronic nosie for better low signal performace and thermal management. Identical to the predicate, Revolution Maxima generates cross-sectional images of the body by computer reconstruction of x-ray transmission data taken at different angles and planes, including Axial, Cine, Helical (Volumetric), Cardiac, and Gated acquisitions modes. Revolution Maxima's Intended Use and Indications for Use remain identical to those of the predicate device. The Revolution Maxima CT system is a head and whole body CT system incorporating the same basic fundamental operating principles and the same indications for use as the predicate device. It's materials and construction are identical to our existing marketed products. Revolution Maxima remains compliant with IEC 60601-1 Ed. 3.1 and associated collateral and particular standards, NEMA XR 25, XR 28, and 21 CFR Subchapter J performance standards. The accompanying documents also contain the information in support of IEC61223-3-5 Ed. 1.0 for acceptance testing. The performance and image quality specifications are identical/equivalent to the predicate. The gantry has a 70 cm bore with a maximum FOV of 50 cm. Available rotation speeds range from 0.35 to 2.0 seconds. Same as the predicate, the Revolution Maxima has three types of reconstruction methods available: FBP, ASiR, and ASiR-V (K133640). The performance of ASiR-V on Revolution Maxima is identical to that on the predicate Optima CT660. Revolution Maxima includes most of the available features on the current production predicate device Optima CT660. The new changes incorporated into Revolution Maxima are primarily addition of a few features found on other GE current production CT systems, e.g. updated newer ITE host computer, Digital Tilt as an alternative to the tilted gantry, improved metal artifacts reduction called Smart MAR and 1024x1024 Recon. Digital Tilt is a software reformatting of the reconstructed images so that they appear like those reconstructed from a tilted gantry. The smaller pixel sizes of 1024 Recon improves the spatial resolution which is useful in clinical applications that would benefit from increased spatial resolution, especially those applications where a large display field of view is desired to simultaneously image corresponding left/right anatomy for comparison (e.g. highresolution lungs, internal auditory canals). There are other unique changes for Revolution Maxima which includes new gantry covers with more aesthetic and modern industry design, new gantry display panel on two tablets with high resolution touchscreens, one on each side of the gantry for improved access and usability. These gantry display tablets replace the single display screen located at the top center of the gantry in the predicate device and host the web based user interface for a new and improved workflow called "Express mode" which seamlessly displays the related protocols associated with order information in the RIS
More Information

No
The summary describes standard CT image processing and reconstruction techniques (FBP, ASiR, ASiR-V, Digital Tilt, Smart MAR, 1024x1024 Recon) which are not explicitly stated to utilize AI/ML. There is no mention of AI, ML, deep learning, or related terms.

No.
The device is used for diagnosis and planning/guiding/monitoring therapy, but it does not directly perform therapy itself. Its primary function is imaging.

Yes

Explanation: The "Intended Use / Indications for Use" section explicitly states, "The device output is a valuable medical tool for the diagnosis of disease, trauma, or abnormality and for planning, guiding, and monitoring therapy." This directly indicates its role in diagnosis.

No

The device description explicitly states it is composed of hardware components such as a gantry, patient table, operator console, host computer, and power distribution unit, in addition to software.

Based on the provided text, 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 produces cross-sectional images of the body using x-ray transmission data. It's an imaging device that works by scanning the patient directly.
  • No Specimen Analysis: There is no mention of analyzing biological specimens taken from the patient. The device interacts directly with the patient's body.

Therefore, this device falls under the category of medical imaging devices, not In Vitro Diagnostics.

N/A

Intended Use / Indications for Use

The system is intended to produce cross-sectional images of the body by computer reconstruction of x-ray transmission data taken at different angles and planes, including Axial, Cine, Helical (Volumetric), Cardiac, and Gated acquisitions. These images may be obtained either with or without contrast. This device may include signal analysis and display equipment, patient and equipment supports, components and accessories.

This device may include data and image processing to produce images in a variety of trans-axial and reformatted planes. Further the images can be post processed to produce additional imaging planes or analysis results.

The system is indicated for head, whole body, cardiac and vascular X-ray Computed Tomography applications in patients of all ages.

The device output is a valuable medical tool for the diagnosis of disease, trauma, or abnormality and for planning, guiding, and monitoring therapy.

Product codes

JAK

Device Description

The Revolution Maxima CT system is composed of a gantry, patient table, operator console, host computer, and power distribution unit (PDU), and interconnecting cables. The system also includes image acquisition and reconstruction hardware/software, general system software, accompanying documents, and associated accessories, interconnections. The Revolution Maxima system is an evolutionary configuration of the predicate Optima CT660 CT system (K131576). All of the hardware functionality is identical to the predicate, however, some hardware changes have been made that did not change the system's performance specifications such as the new liquid metal bearing tube for improved tube life and reliability, the upgraded DAS and detector to improve the manufacturability and lower electronic nosie for better low signal performace and thermal management.

Identical to the predicate, Revolution Maxima generates cross-sectional images of the body by computer reconstruction of x-ray transmission data taken at different angles and planes, including Axial, Cine, Helical (Volumetric), Cardiac, and Gated acquisitions modes. Revolution Maxima's Intended Use and Indications for Use remain identical to those of the predicate device.

The Revolution Maxima CT system is a head and whole body CT system incorporating the same basic fundamental operating principles and the same indications for use as the predicate device. It's materials and construction are identical to our existing marketed products. Revolution Maxima remains compliant with IEC 60601-1 Ed. 3.1 and associated collateral and particular standards, NEMA XR 25, XR 28, and 21 CFR Subchapter J performance standards. The accompanying documents also contain the information in support of IEC61223-3-5 Ed. 1.0 for acceptance testing.

The performance and image quality specifications are identical/equivalent to the predicate. The gantry has a 70 cm bore with a maximum FOV of 50 cm. Available rotation speeds range from 0.35 to 2.0 seconds. Same as the predicate, the Revolution Maxima has three types of reconstruction methods available: FBP, ASiR, and ASiR-V (K133640). The performance of ASiR-V on Revolution Maxima is identical to that on the predicate Optima CT660.

Revolution Maxima includes most of the available features on the current production predicate device Optima CT660. The new changes incorporated into Revolution Maxima are primarily addition of a few features found on other GE current production CT systems, e.g. updated newer ITE host computer, Digital Tilt as an alternative to the tilted gantry, improved metal artifacts reduction called Smart MAR and 1024x1024 Recon. Digital Tilt is a software reformatting of the reconstructed images so that they appear like those reconstructed from a tilted gantry. The smaller pixel sizes of 1024 Recon improves the spatial resolution which is useful in clinical applications that would benefit from increased spatial resolution, especially those applications where a large display field of view is desired to simultaneously image corresponding left/right anatomy for comparison (e.g. highresolution lungs, internal auditory canals).

There are other unique changes for Revolution Maxima which includes new gantry covers with more aesthetic and modern industry design, new gantry display panel on two tablets with high resolution touchscreens, one on each side of the gantry for improved access and usability. These gantry display tablets replace the single display screen located at the top center of the gantry in the predicate device and host the web based user interface for a new and improved workflow called "Express mode" which seamlessly displays the related protocols associated with order information in the RIS Intended Use:

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Computed Tomography x-ray

Anatomical Site

head, whole body, cardiac and vascular

Indicated Patient Age Range

patients of all ages

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

Non-Clinical Testing:
The verification and validation testing have been successfully completed as required by design control procedures under GE Healthcare's quality system. This includes risk management, software verification and validation testing as well as image quality and dose performance using standard IQ and QA phantoms, such as Metal artifact reduction(MAR) testing, image quality testing on 1024 Recon and the performance testing in accordance with IEC 61223-3-5 ed 2 (FDIS).
Non-clinical bench test results demonstrated the subject device performs equivalently to the predicate device.

Clinical Testing:
The Revolution Maxima can be fully tested on the engineering bench thus no additional clinical testing was required.

Key Metrics

Not Found

Predicate Device(s)

K131576

Reference Device(s)

K133640

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 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.

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October 24, 2019

GE Hangwei Medical Systems Co.,Ltd. % Haibo He Regulatory Affairs Leader West Area of Building No.3, No.1 Yongchang North Road Economic and Technological Development Area. Beijing 100176 CHINA

Re: K192686

Trade/Device Name: Revolution Maxima Regulation Number: 21 CFR 892.1750 Regulation Name: Computed tomography x-ray system Regulatory Class: Class II Product Code: JAK Dated: September 25, 2019 Received: September 26, 2019

Dear Haibo He:

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

1

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/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); 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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). 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 (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Thalia T. Mills, Ph.D. Director Division of Radiological Health OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

2

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known)

K192686

Device Name Revolution Maxima

Indications for Use (Describe)

The system is intended to produce cross-sectional images of the body by computer reconstruction of x-ray transmission data taken at different angles and planes, including Axial, Cine, Helical (Volumetric), Cardiac, and Gated acquisitions. These images may be obtained either with or without contrast. This device may include signal analysis and display equipment, patient and equipment supports, components and accessories.

This device may include data and image processing to produce images in a variety of trans-axial and reformatted planes. Further the images can be post processed to produce additional imaging planes or analysis results.

The system is indicated for head, whole body, cardiac and vascular X-ray Computed Tomography applications in patients of all ages.

The device output is a valuable medical tool for the diagnosis of disease, trauma, or abnormality and for planning, guiding, and monitoring therapy.

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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Image /page/3/Picture/1 description: The image shows the General Electric (GE) logo. The logo consists of the letters "GE" in a stylized script, enclosed within a blue circle. The circle is surrounded by a white border with four stylized water droplets or wave-like shapes, one at each cardinal direction. The logo is simple, clean, and recognizable.

GE Healthcare 510(k) Premarket Notification Submission for Revolution Maxima

510(k) Summary

This 510(k) summary of Safety and Effectiveness information is submitted in accordance with the requirement of 21 CFR Part 807.87(h).

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

Date:September 25, 2019
Submitter:GE Hangwei Medical Systems Co.,Ltd.
West Area of Building No.3, No.1 Yongchang North
Road, Beijing Economic and Technological Development
Area, BEIJING 100176 CHINA
Primary Contact Person:Haibo He
Regulatory Affairs Leader
GE Healthcare
Phone Number: (86)-10-57083413
e-mail: Haibo.he1@ge.com
Secondary Contact Persons:John Jaeckle
Chief Regulatory Affairs Strategist
GE Healthcare
Phone Number: 262-424-9547
e-mail: John.Jaeckle.com

Helen Peng
Sr Regulatory Affairs Director
GE Healthcare
Phone Number: 262-4248222
e-mail: hong.peng@ge.com |
| Product Identification | Revolution Maxima |
| Device Trade Name: | Revolution Maxima |
| Common/Usual Name: | Revolution Ace |
| Regulation Number
/ Classification: | Computed Tomography X-ray System, 21 CFR 892.1750
/ Class II |

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Image /page/4/Picture/0 description: The image shows the logo for General Electric (GE). The logo is a blue circle with the letters "GE" in a stylized font in the center. There are three white teardrop shapes around the outside of the circle. The logo is simple and recognizable.

510(k) Premarket Notification Submission for Revolution Maxima

Product Code:90-JAK
ManufacturerGE Hangwei Medical Systems Co.,Ltd.
West Area of Building No.3, No.1 Yongchang North
Road, Beijing Economic and Technological Development
Area, BEIJING 100176 CHINA
Predicate Device Information:
Device NameOptima CT660
510 (K) numberK131576 cleared on August, 2013
Regualation Number/
ClassificationComputed Tomography X-ray System, 21 CFR 892.1750 /
Class II
Product Code90-JAK

Marketed Devices:

The Revolution Maxima is a CT device built upon the existing technologies of the predicate device, GE Healthcare' s currently marketed Computed Tomography X-ray System Optima CT660 (K131576). It is of comparable type and substantially equivalent to Optima CT660. In addition, the system has the same intended use and indication for use as that of the predicate device. The system is labeled as the Revolution Maxima, with an alternate name Revolution Ace.

Device Description:

The Revolution Maxima CT system is composed of a gantry, patient table, operator console, host computer, and power distribution unit (PDU), and interconnecting cables. The system also includes image acquisition and reconstruction hardware/software, general system software, accompanying documents, and associated accessories, interconnections. The Revolution Maxima system is an evolutionary configuration of the predicate Optima CT660 CT system (K131576). All of the hardware functionality is identical to the predicate, however, some hardware changes have been made that did not change the system's performance specifications such as the new liquid metal bearing tube for improved tube life and reliability, the upgraded DAS and detector to improve the manufacturability and lower electronic nosie for better low signal performace and thermal management.

ldentical to the predicate, Revolution Maxima generates cross-sectional images of the body by computer reconstruction of x-ray transmission data taken at different angles and planes,

5

Image /page/5/Picture/0 description: The image shows the logo for General Electric (GE). The logo consists of the letters "GE" written in a stylized, cursive font, enclosed within a blue circle. The circle has a white border with wave-like designs, giving it a dynamic and modern appearance. The blue color is consistent throughout the logo, providing a clean and recognizable brand identity.

510(k) Premarket Notification Submission for Revolution Maxima

including Axial, Cine, Helical (Volumetric), Cardiac, and Gated acquisitions modes. Revolution Maxima's Intended Use and Indications for Use remain identical to those of the predicate device.

The Revolution Maxima CT system is a head and whole body CT system incorporating the same basic fundamental operating principles and the same indications for use as the predicate device. It's materials and construction are identical to our existing marketed products. Revolution Maxima remains compliant with IEC 60601-1 Ed. 3.1 and associated collateral and particular standards, NEMA XR 25, XR 28, and 21 CFR Subchapter J performance standards. The accompanying documents also contain the information in support of IEC61223-3-5 Ed. 1.0 for acceptance testing.

The performance and image quality specifications are identical/equivalent to the predicate. The gantry has a 70 cm bore with a maximum FOV of 50 cm. Available rotation speeds range from 0.35 to 2.0 seconds. Same as the predicate, the Revolution Maxima has three types of reconstruction methods available: FBP, ASiR, and ASiR-V (K133640). The performance of ASiR-V on Revolution Maxima is identical to that on the predicate Optima CT660.

Revolution Maxima includes most of the available features on the current production predicate device Optima CT660. The new changes incorporated into Revolution Maxima are primarily addition of a few features found on other GE current production CT systems, e.g. updated newer ITE host computer, Digital Tilt as an alternative to the tilted gantry, improved metal artifacts reduction called Smart MAR and 1024x1024 Recon. Digital Tilt is a software reformatting of the reconstructed images so that they appear like those reconstructed from a tilted gantry. The smaller pixel sizes of 1024 Recon improves the spatial resolution which is useful in clinical applications that would benefit from increased spatial resolution, especially those applications where a large display field of view is desired to simultaneously image corresponding left/right anatomy for comparison (e.g. highresolution lungs, internal auditory canals).

There are other unique changes for Revolution Maxima which includes new gantry covers with more aesthetic and modern industry design, new gantry display panel on two tablets with high resolution touchscreens, one on each side of the gantry for improved access and usability. These gantry display tablets replace the single display screen located at the top center of the gantry in the predicate device and host the web based user interface for a new and improved workflow called "Express mode" which seamlessly displays the related protocols associated with order information in the RIS Intended Use:

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Image /page/6/Picture/0 description: The image shows the General Electric (GE) logo. The logo consists of the letters 'GE' in a stylized script, enclosed within a circular frame. The frame has a wavy design, resembling water or energy currents. The logo is colored in a bright blue hue.

510(k) Premarket Notification Submission for Revolution Maxima

The system is intended to be used for head, whole body Computed Tomography applications.

Indications for Use:

The system is intended to produce cross-sectional images of the body by computer reconstruction of x-ray transmission data taken at different angles and planes, including Axial, Cine, Helical (Volumetric), Cardiac, and Gated acquisitions. These images may be obtained either with or without contrast. This device may include signal analysis and display equipment, patient and equipment supports, components and accessories.

This device may include data and image processing to produce images in a variety of transaxial and reformatted planes. Further the images can be post processed to produce additional imaging planes or analysis results.

The system is indicated for head, whole body, cardiac and vascular X-ray Computed Tomography applications in patients of all ages.

The device output is a valuable medical tool for the diagnosis of disease, trauma, or abnormality and for planning, guiding, and monitoring therapy.

Technology:

Revolution Maxima includes most of the available features on the current production predicate device Optima CT660 and employs the same fundmental technologies as those of the predicate device. The changes incorporated into Revolution Maxima are primarily addition of a few features found on other GE current production CT systems, e.g. updated newer host computer, There are other unique changes for Revolution Maxima which are primarily for new industry design, IQ improvement, and workflow optimization. These include new gantry covers, new gantry display panel with two tablets located on both sides of the gantry with web based UI to auto display related protocols associated with order information in the RIS.

The table below summarizes the substantive feature/technological differences between the predicate device and the proposed device:

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Image /page/7/Picture/0 description: The image shows the logo for General Electric (GE). The logo is a blue circle with the letters "GE" in a stylized font in the center. There are decorative swirls around the outside of the circle. The logo is simple and recognizable, and it is associated with a well-known company.

510(k) Premarket Notification Submission for Revolution Maxima

| Subsystem | Predicate Device
Optima CT660 (K131576) | Proposed Device
Revolution Maxima |
|--------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Gantry Display
Panel | Gantry Display

  • Video touchscreen on top
    center of gantry
  • Emergency patient exam
  • Display gantry and table
    position information.
  • Display multiple system
    status.
  • Display patient and exam
    information.
  • Display Patient ECG
    waveform.
  • Default Patient Positioning
    (DPP).
  • Play movie. | Gantry Display
    "Xtream Tablet" (the "tablet"
    is not removable)
  • HD Video touchscreen on
    each side of gantry
  • New-Patient/Emergency
    Patient exam.
  • Display gantry and table
    position information.
  • Display multiple system
    status.
  • Display patient and exam
    information.
  • Display Patient ECG
    waveform.
  • Default Patient Positioning
    (DPP).
  • Play movie. |
    | 1024x1024 Image
    Recon | Not Available | Available |
    | Related Protocols | Not Available | Available |
    | Smart MAR | Not Available | Available |
    | Tilt | Physical tilt | Digital Tilt |

The changes described above do not change the fundamental control mechanism, operating principle, energy type, and do not change the intended use from the predicate device Optima CT660.

Risk Analysis:

Potential electrical, mechanical, and radiation hazards are identified in risk management including hazard analysis and controlled by:

  • । System verification and validation to ensure performance to specifications, Federal Regulations, and user requirements.

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Image /page/8/Picture/0 description: The image shows the logo for GE, which is a well-known multinational conglomerate. The logo consists of the letters 'GE' written in a stylized, cursive font. The letters are enclosed within a blue circle, and there are decorative water droplet-like shapes surrounding the circle. The overall design is simple, clean, and recognizable.

510(k) Premarket Notification Submission for Revolution Maxima

  • -Adherence and certification to industry and international standards. (UL/CSA and IEC60601-1 Ed.3.1 and associated collateral and particular standards for CT).
  • Compliance to applicable CDRH 21 CFR subchapter J requirements. -
  • Compliance to NEMA XR 25, XR 26, and XR 28.

The device is designed and manufactured under the Quality System Regulations of 21 CFR 820 and ISO 13485.

Determination of Substantial Equivalence:

The Revolution Maxima has completed testing and in compliance with AAMI/ANSI ES 60601-1 and IEC60601-1 Ed. 3.1 and its associated collateral and particular standards, 21 CFR Subchapter J, and NEMA standards XR 25, XR 26, and XR 28. The device has successfully completed all testing per our quality system as well as addition engineering bench testing in support of this submission. It was designed and is manufactured under the Quality System Regulations of 21 CFR 820 and ISO 13485. The following quality assurance measures were applied to the development of the system:

  • Risk Analysis
  • Required Reviews
  • Design Reviews
  • Testing on unit level (Module verification)
  • · Integration testing (System verification)
  • Performance testing (Verification)
  • · Safety testing (Verification)
  • Simulated use testing (Validation)

GE believes the Revolution Maxima system is of comparable type and substantially equivalent to our currently marketed system Optima CT660(K131576).

The substantial equivalence was also based on software documentation for a "Moderate" level of concern device.

Summary of Additional Testing

Non-Clinical Testing:

The verification and validation testing have been successfully completed as required by design control procedures under GE Healthcare's quality system. This includes risk management, software verification and validation testing as well as image quality and dose performance using standard IQ and QA phantoms, such as Metal artifact

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Image /page/9/Picture/0 description: The image shows the General Electric (GE) logo. The logo consists of the letters 'GE' in a stylized, cursive font, enclosed within a circular border. The letters and the border are in a light blue color. There are also three white water droplet shapes around the border of the circle.

510(k) Premarket Notification Submission for Revolution Maxima

reduction(MAR) testing, image quality testing on 1024 Recon and the performance testing in accordance with IEC 61223-3-5 ed 2 (FDIS).

Non-clinical bench test results demonstrated the subject device performs equivalently to the predicate device.

Clinical Testing:

The Revolution Maxima can be fully tested on the engineering bench thus no additional clinical testing was required.

Substantial Equivalence Conclusion:

Based on the conformance to standards, development under our quality system, and the engineering testing provided, GE Healthcare believes that the Revolution Maxima is as safe and effective, and performs in a substantially equivalent manner to the predicate device Optima CT660 (K131576).