(135 days)
The SIGNA Premier system is a whole body magnetic resonance scanner designed to support high signal-to-noise ratio, and short scan times. It is indicated for use as a diagnostic imaging device to produce axial, sagittal, coronal, and oblique images, spectroscopic images, parametric maps, and/or spectra, dynamic images of the structures and/or functions of the entire body, including, but not limited to, head, neck, TMJ, spine, breast, heart, abdomen, pelvis, joints, prostate, blood vessels, and musculoskeletal regions of the body. Depending on the region of interest being imaged, contrast agents may be used.
The images produced by the SIGNA Premier system reflect the spatial distribution or molecular environment of nuclei exhibiting magnetic resonance. These images and/or spectra when interpreted by a trained physician vield information that may assist in diagnosis.
SIGNA Premier is a whole-body magnetic resonance scanner featuring a 3.0T superconducting magnet with a 70cm bore size. Major elements of the system include the magnet, gradient coils, body RF transmit coil, RF receive subsystem, patient support system (table), host computer, and system software. The system is compatible with a suite of RF receive coils, and is capable of using various pulse sequences, imaging techniques and reconstruction algorithms.
This submission is prompted by the introduction of a new software feature called AIR Recon DL onto the SIGNA Premier system. AIR Recon DL is a deep-learning based reconstruction technique designed to improve signal-to-noise ratio (SNR) and image sharpness. The feature also enables shorter scan times while preserving SNR and image sharpness.
The addition of the AIR Recon DL feature involved modifications to the SIGNA Premier system software. There were no changes related to AIR Recon DL to the system's hardware components.
The provided text describes the acceptance criteria and supporting studies for the SIGNA Premier system with the AIR Recon DL feature. However, it does not explicitly provide a table of acceptance criteria with reported device performance or all the specific details requested in question points 2 through 9.
Based on the available information, here's what can be extracted:
1. Table of Acceptance Criteria and Reported Device Performance:
| Acceptance Criteria (Inferred) | Reported Device Performance (AIR Recon DL) |
|---|---|
| Improvement in Signal-to-Noise Ratio (SNR) | Nonclinical: AIR Recon DL improves SNR.Clinical: Objective measures of in vivo images confirmed AIR Recon DL improves SNR. Radiologists indicated a preference for AIR Recon DL images, implying improved SNR contributed to perceived image quality. |
| Improvement in Image Sharpness | Nonclinical: AIR Recon DL improves image sharpness.Clinical: Objective measures of in vivo images confirmed AIR Recon DL improves image sharpness. Radiologists indicated a preference for AIR Recon DL images, implying improved sharpness contributed to perceived image quality. |
| Ability to Enable Shorter Scan Times (while maintaining SNR/sharpness) | Nonclinical: AIR Recon DL was able to maintain image SNR and did not sacrifice sharpness for images acquired with a reduced scan time.Clinical: Comparisons were made between AIR Recon DL images from shorter scan time acquisitions and images without AIR Recon DL taken with longer scan times, with results confirming equivalent or better image quality for AIR Recon DL images. |
| Low Contrast Detectability | Nonclinical: Maintained (did not negatively impact). |
| Noise Spectral Content | Nonclinical: Minimal impacts to. |
| Bias in Quantitative Measurements (based on signal intensity) | Nonclinical: No significant bias identified. |
| Appearance of Motion Artifacts | Nonclinical: Minimal impacts to (did not negatively impact). |
| Legibility of Clinically Relevant Structures | Clinical: Reader evaluation confirmed that AIR Recon DL provides images with equivalent or better image quality in terms of the legibility of clinically relevant structures. |
| Lesion Conspicuity | Clinical: Maintained with AIR Recon DL. |
| Overall Clinical Preference | Clinical: Radiologists reading the images indicated a preference for the AIR Recon DL images. Radiologists preferred the AIR Recon DL images for clinical use, even for samples with exogenous contrast and various pathologies. |
| Safety and Performance | Overall Conclusion: The nonclinical and clinical testing did not identify any new hazards, adverse effects, or safety or performance concerns that are significantly different from those associated with MR imaging in general. The device is at least as safe and effective as the predicate. |
2. Sample size used for the test set and the data provenance:
- Test Set Sample Size: The document mentions "objective measures of in vivo images" and a "reader evaluation study" on "images acquired across a variety of pulse sequences and anatomies," and "sample images from clinically indicated scans." However, the specific number of images or patient cases used for these test sets is not provided.
- Data Provenance: The document states "in vivo images" and "clinically indicated scans." This implies retrospective clinical data, but the country of origin is not specified.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:
- Number of Experts: The document states "Radiologists were asked to perform blinded reads" and "Radiologists were asked to rate the images." The specific number of radiologists/experts involved is not provided.
- Qualifications of Experts: The experts are identified as "Radiologists," but their specific qualifications (e.g., years of experience, subspecialty) are not provided.
4. Adjudication method for the test set:
- The document implies that radiologists provided ratings and comments, and the results were aggregated to conclude on preference and image quality. However, a formal adjudication method like "2+1" or "3+1" to establish a consensus ground truth among multiple readers is not explicitly stated or described. The reads were "blinded," but it doesn't detail how discrepancies were resolved or if there was a consensus process.
5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance:
- MRMC Study: A "reader evaluation study" was performed where "Radiologists were asked to perform blinded reads of both AIR Recon DL images and images without AIR Recon DL." This indicates a comparative reading study was conducted. Also, "Comparisons were also made between AIR Recon DL images from shorter scan time acquisitions and images without AIR Recon DL taken with longer scan times."
- Effect Size: The document states that the results "confirmed that the AIR Recon DL feature provides images with equivalent or better image quality in terms of the legibility of clinically relevant structures." It also notes "the radiologists reading the images also indicated a preference for the AIR Recon DL images." However, a specific quantifiable effect size measuring how much human readers improve (e.g., in terms of diagnostic accuracy, confidence, or reading time) with AI assistance compared to without it is not provided. The improvement is described qualitatively (equivalent or better image quality, preference).
6. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done:
- The nonclinical testing on a "digital reference object and phantom imaging" evaluated the algorithm's impact on image quality metrics (SNR, sharpness, low contrast detectability, noise spectral content, bias, motion artifacts). This constitutes a standalone performance assessment of the algorithm's effects on image characteristics.
7. The type of ground truth used:
- For nonclinical testing (phantoms), the ground truth is known physical properties or measurements of the reference object/phantom.
- For clinical testing, the ground truth is established through expert consensus/ratings by radiologists. The document refers to "legibility of clinically relevant structures" and "lesion conspicuity" being maintained, relying on expert interpretation rather than pathology or long-term outcomes data.
8. The sample size for the training set:
- The document describes the AIR Recon DL feature as "a deep-learning based reconstruction technique." However, it does not provide any information regarding the sample size of the training set used to develop this deep learning model.
9. How the ground truth for the training set was established:
- As the document does not provide information about the training set (sample size or data), it does not describe how the ground truth for the training set was established.
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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 and Human Services logo. To the right of that 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.
GE Healthcare (GE Medical Systems, LLC) % Mr. Glen Sabin Regulatory Affairs Director, MR 3200 N Grandview Blvd. WAUKESHA WI 53188
April 10, 2020
Re: K193282
Trade/Device Name: SIGNA Premier Regulation Number: 21 CFR 892.1000 Regulation Name: Magnetic resonance diagnostic device Regulatory Class: Class II Product Code: LNH, LNI, MOS Dated: March 11, 2020 Received: March 12, 2020
Dear Mr. Sabin:
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 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
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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,
For
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
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Indications for Use
510(k) Number (if known)
K193282
Device Name
SIGNA Premier
Indications for Use (Describe)
The SIGNA Premier system is a whole body magnetic resonance scanner designed to support high signal-to-noise ratio, and short scan times. It is indicated for use as a diagnostic imaging device to produce axial, sagittal, coronal, and oblique images, spectroscopic images, parametric maps, and/or spectra, dynamic images of the structures and/or functions of the entire body, including, but not limited to, head, neck, TMJ, spine, breast, heart, abdomen, pelvis, joints, prostate, blood vessels, and musculoskeletal regions of the body. Depending on the region of interest being imaged, contrast agents may be used.
The images produced by the SIGNA Premier system reflect the spatial distribution or molecular environment of nuclei exhibiting magnetic resonance. These images and/or spectra when interpreted by a trained physician vield information that may assist in diagnosis.
| 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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GE Healthcare
510(k) Premarket Notification Submission SIGNA Premier
510(k) Summary
In accordance with 21 CFR 807.92 the following summary of information is provided:
| Date: | 26 November 2019 |
|---|---|
| Submitter: | GE Medical Systems, LLC3200 N. Grandview Blvd.Waukesha, WI 53188 |
| Primary Contact: | Glen SabinRegulatory Affairs DirectorPhone: 262 521-6848Email: Glen.Sabin@GE.com |
| Secondary Contact: | Jim McMahonSenior Director - Regulatory AffairsPhone: 508 382-2858Email: James.D.McMahon@GE.com |
| Device Trade Name: | SIGNA Premier |
| Common / Usual Name: | MR System |
| Classification Name:Regulation Number:Primary Product Code:Secondary Product Codes: | Magnetic Resonance Diagnostic Device21 CFR 892.1000LNHLNI, MOS |
| Predicate Device:510(k) Number:Device Name:Manufacturer: | K183231SIGNA PremierGE Medical Systems, LLC |
Device Description:
SIGNA Premier is a whole-body magnetic resonance scanner featuring a 3.0T superconducting magnet with a 70cm bore size. Major elements of the system include the magnet, gradient coils, body RF transmit coil, RF receive subsystem, patient support system (table), host computer, and system software. The system is compatible with a suite of RF receive coils, and is capable of using various pulse sequences, imaging techniques and reconstruction algorithms.
This submission is prompted by the introduction of a new software feature called AIR Recon DL onto the SIGNA Premier system. AIR Recon DL is a deep-learning based reconstruction technique designed to improve signal-to-noise ratio (SNR) and image sharpness. The feature also enables shorter scan times while preserving SNR and image sharpness.
The addition of the AIR Recon DL feature involved modifications to the SIGNA Premier system software. There were no changes related to AIR Recon DL to the system's hardware components.
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Indications for Use:
The Indications for Use statement for the proposed device is identical to that of the predicate device:
The SIGNA Premier system is a whole body magnetic resonance scanner designed to support high resolution, high signal-to-noise ratio, and short scan times. It is indicated for use as a diagnostic imaging device to produce axial, sagittal, coronal, and oblique images, spectroscopic images, parametric maps, and/or spectra, dynamic images of the structures and/or functions of the entire body, including, but not limited to, head, neck, TMJ, spine, breast, heart, abdomen, pelvis, joints, prostate, blood vessels, and musculoskeletal regions of the body. Depending on the region of interest being imaged, contrast agents may be used.
The images produced by the SIGNA Premier system reflect the spatial distribution or molecular environment of nuclei exhibiting magnetic resonance. These images and/or spectra when interpreted by a trained physician yield information that may assist in diagnosis.
The addition of the AIR Recon DL feature does not impact the intended use of the SIGNA Premier system.
Comparison of Technological Characteristics:
Many of the technological characteristics of the proposed SIGNA Premier system are unchanged from the predicate device. There are no changes to the magnet, gradient, and RF subsystems compared to the predicate K183231. Key performance specifications (such as magnet homogeneity and stability, maximum gradient strength and slew rate, etc.) for the system are also unchanged.
The software used on the proposed SIGNA Premier system has been modified to include the AR Recon DL feature. The user interface provides operators of the system with new options for selecting AIR Recon DL and adjusting the associated level of image noise reduction. The resulting images can have higher SNR and improved sharpness compared to images reconstructed without AIR Recon DL.
Summary of Nonclinical Testing:
The AIR Recon DL feature has undergone testing with a digital reference object and phantom imaging. These tests were designed to evaluate the AIR Recon DL feature and its impact on image quality, including SNR, sharpness, low contrast detectability, and noise spectral content. Analysis was performed to confirm that the feature does not introduce significant bias that might impact quantitative measurements based on signal intensity. The influence of motion during image acquisition on the performance of AIR Recon DL was also evaluated.
The nonclinical testing demonstrated that AIR Recon DL does improve SNR and image sharpness while maintaining low contrast detectability and having minimal impacts to noise spectral content, average signal intensity, or the appearance of motion artifacts. AIR Recon DL was also able to maintain image SNR and did not sacrifice sharpness for images acquired with a reduced scan time. The nonclinical testing passed the defined acceptance criteria, and did not identify any adverse impacts to image quality or other concerns related to safety and performance.
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Summary of Clinical Testing:
Objective measures of in vivo images were analyzed to confirm that AIR Recon DL improves SNR and image sharpness for typical clinical use cases.
A reader evaluation study was performed on AIR Recon DL images acquired across a variety of pulse sequences and anatomies. Radiologists were asked to perform blinded reads of both AIR Recon DL images and images without AL Recon DL. Comparisons were also made between AlR Recon DL images from shorter scan time acquisitions and images without AIR Recon DL taken with longer scan times. The results confirmed that the AIR Recon DL feature provides images with equivalent or better image quality in terms of the legibility of clinically relevant structures. The radiologists reading the images also indicated a preference for the AIR Recon DL images.
Additionally, sample images from clinically indicated scans were evaluated both with and without the AIR Recon DL feature. These samples included images using exogenous contrast and images involving pathology spanning a variety of anatomies and pulse sequences. Radiologists were asked to rate the images, and to comment on any notable aspects related to image quality. This study showed that lesion conspicuity is maintained with AIR Recon DL, and that the radiologists preferred the AIR Recon DL images for clinical use.
Conclusions Drawn from Performance Testing:
The nonclinical and clinical testing demonstrated that AIR Recon DL satisfies the product claims of improved SNR and image sharpness, and can enable shorter scan times while maintaining SNR and image sharpness.
The proposed SIGNA Premier system with AIR Recon DL has been developed under GE Healthcare's quality system and is at least as safe and effective as the legally marketed predicate. The performance testing did not identify any new hazards, adverse effects, or safety or performance concerns that are significantly different from those associated with MR imaging in general.
Therefore, GE Healthcare believes that SIGNA Premier with AIR Recon DL is substantially equivalent to the predicate device, and is safe and effective for its intended use.
§ 892.1000 Magnetic resonance diagnostic device.
(a)
Identification. A magnetic resonance diagnostic device is intended for general diagnostic use to present images which reflect the spatial distribution and/or magnetic resonance spectra which reflect frequency and distribution of nuclei exhibiting nuclear magnetic resonance. Other physical parameters derived from the images and/or spectra may also be produced. The device includes hydrogen-1 (proton) imaging, sodium-23 imaging, hydrogen-1 spectroscopy, phosphorus-31 spectroscopy, and chemical shift imaging (preserving simultaneous frequency and spatial information).(b)
Classification. Class II (special controls). A magnetic resonance imaging disposable kit intended for use with a magnetic resonance diagnostic device only is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 892.9.