K Number
K193658
Device Name
Viz ICH
Manufacturer
Date Cleared
2020-03-18

(79 days)

Product Code
Regulation Number
892.2080
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Viz ICH is a notification-only, parallel workflow tool for use by hospital networks and trained clinicians to identify and communicate images of specific patients to a specialist, independent of care workflow. Viz ICH uses an artificial intelligence algorithm to analyze images for findings suggestive of a prespecified clinical condition and to notify an appropriate medical specialist of these findings in parallel to standard of care image interpretation. Identification of suspected findings is not for diagnostic use beyond notification. Specifically, the device analyzes non-contrast CT images of the brain acquired in the acute setting, and sends notifications to a neurovascular or neurosurgical specialist that a suspected intracranial hemorrhage has been identified and recommends review of those images. Images can be previewed through a mobile application. lmages that are previewed through the mobile application may be compressed and are for informational purposes only and not intended for diagnostic use beyond notification. Notified clinicians are responsible for viewing non-compressed images on a diagnostic viewer and engaging in appropriate patient evaluation and relevant discussion with a treating physician before making care-related decisions or requests. Viz ICH is limited to analysis of imaging data and should not be used in-lieu of full patient evaluation or relied upon to make or confirm diagnosis. Viz ICH is contraindicated for analyzing non-contrast CT scans that are acquired on scanners from manufacturers other than General Electric (GE) or its subsidiaries (i.e. GE Healthcare). This contraindication applies to NCCT scans that conform to all applicable Patient Inclusion Criteria, are of adequate technical image quality, and would otherwise be expected to be analyzed by the device for a suspected ICH.
Device Description
Viz ICH is a software-only, parallel workflow tool for use by hospital networks and trained clinicians to identify and communicate images of specific patients to an appropriate specialist, such as a neurovascular specialist or neurosurgeon, independent of the standard of care workflow. The system automatically receives and analyzes non-contrast CT (NCCT) studies of patients for image features that indicate the presence of an intracranial hemorrhage (ICH) using an artificial intelligence algorithm, and upon detection of a suspected ICH, sends a notification so as to alert a specialist clinician of the case. Viz ICH consists of backend and mobile application component software. The Backend software includes a DICOM router and backend server. The DICOM router transmits NCCT images of the head acquired on a local healthcare network to the Backend Server. The Backend Server receives, stores, processes and serves received NCCT scans. The Backend Server also includes an artificial intelligence algorithm that analyzes the received NCCT images for image characteristics that indicate an intracranial haemorrhage (ICH) and, upon detection, sends a notification of the suspected finding to pre-determined specialists. The Viz ICH Mobile Application software receives notifications generated by the Backend of suspected image findings and allows the notification recipient to view the analyzed NCCT images through a non-diagnostic viewer, as well as patient information that was embedded in the image metadata. Image viewing through the mobile application is for informational purposes only and is not intended for diagnostic use.
More Information

Yes
The device description explicitly states that it uses an "artificial intelligence algorithm" to analyze images for findings suggestive of a prespecified clinical condition.

No.
The device identifies and communicates images for notification purposes, not for direct treatment or therapy.

No

The text explicitly states: "Identification of suspected findings is not for diagnostic use beyond notification" and "Viz ICH is limited to analysis of imaging data and should not be used in-lieu of full patient evaluation or relied upon to make or confirm diagnosis."

Yes

The device description explicitly states "Viz ICH is a software-only, parallel workflow tool". While it interacts with hardware (CT scanners, mobile devices), the device itself, as described, is solely the software components (backend and mobile application).

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

Here's why:

  • IVDs analyze samples taken from the human body. The description clearly states that Viz ICH analyzes non-contrast CT images of the brain. These are medical images, not biological samples like blood, urine, or tissue.
  • The intended use is for image analysis and notification. The primary function is to identify potential findings in images and alert specialists, not to perform tests on biological specimens to diagnose a condition.
  • The device is a software-only tool for image processing. While it uses AI to analyze images, this is distinct from the laboratory-based tests that characterize IVDs.

The device falls under the category of medical image analysis software, specifically designed to aid in workflow and communication for suspected intracranial hemorrhage based on CT scans.

No
The input states "Control Plan Authorized (PCCP) and relevant text: Not Found", which indicates the letter does not contain explicit approval or clearance of a PCCP for this device, nor does it reference section 515C(b)(1).

Intended Use / Indications for Use

Viz ICH is a notification-only, parallel workflow tool for use by hospital networks and trained clinicians to identify and communicate images of specific patients to a specialist, independent of care workflow.

Viz ICH uses an artificial intelligence algorithm to analyze images for findings suggestive of a prespecified clinical condition and to notify an appropriate medical specialist of these findings in parallel to standard of care image interpretation. Identification of suspected findings is not for diagnostic use beyond notification. Specifically, the device analyzes non-contrast CT images of the brain acquired in the acute setting, and sends notifications to a neurovascular or neurosurgical specialist that a suspected intracranial hemorrhage has been identified and recommends review of those images. Images can be previewed through a mobile application.

lmages that are previewed through the mobile application may be compressed and are for informational purposes only and not intended for diagnostic use beyond notified clinicians are responsible for viewing non-compressed images on a diagnostic viewer and engaging in appropriate patient and relevant discussion with a treating physician before making care-related decisions or requests. Viz ICH is limited to analysis of imaging data and should not be used in-lieu of full patient evaluation or relied upon to make or confirm diagnosis.

Viz ICH is contraindicated for analyzing non-contrast CT scans that are acquired on scanners from manufacturers other than General Electric (GE) or its subsidiaries (i.e. GE Healthcare). This contraindication applies to NCCT scans that conform to all applicable Patient Inclusion Criteria, are of adequate technical image quality, and would otherwise be expected to be analyzed by the device for a suspected ICH.

Product codes

QAS

Device Description

Viz ICH is a software-only, parallel workflow tool for use by hospital networks and trained clinicians to identify and communicate images of specific patients to an appropriate specialist, such as a neurovascular specialist or neurosurgeon, independent of the standard of care workflow. The system automatically receives and analyzes non-contrast CT (NCCT) studies of patients for image features that indicate the presence of an intracranial hemorrhage (ICH) using an artificial intelligence algorithm, and upon detection of a suspected ICH, sends a notification so as to alert a specialist clinician of the case.

Viz ICH consists of backend and mobile application component software. The Backend software includes a DICOM router and backend server. The DICOM router transmits NCCT images of the head acquired on a local healthcare network to the Backend Server. The Backend Server receives, stores, processes and serves received NCCT scans. The Backend Server also includes an artificial intelligence algorithm that analyzes the received NCCT images for image characteristics that indicate an intracranial haemorrhage (ICH) and, upon detection, sends a notification of the suspected finding to pre-determined specialists.

The Viz ICH Mobile Application software receives notifications generated by the Backend of suspected image findings and allows the notification recipient to view the analyzed NCCT images through a non-diagnostic viewer, as well as patient information that was embedded in the image metadata. Image viewing through the mobile application is for informational purposes only and is not intended for diagnostic use.

Mentions image processing

Yes

Mentions AI, DNN, or ML

Yes

Input Imaging Modality

Computed Tomography, non-contrast (NCCT)

Anatomical Site

Brain/Head

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Hospital networks and trained clinicians (neurovascular or neurosurgical specialist)

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

261 non-contrast Computed Tomography (NCCT) scans (studies) were obtained from two clinical sites in the U.S. There were approximately equal numbers of positive and negative cases (47% of images with ICH and 53% without ICH, respectively) included in the analysis. Ground truth was established by trained neuro-radiologists.

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Viz.ai conducted a retrospective study to assess the standalone performance of the image analysis algorithm and notification functionality of Viz ICH. The study evaluated the Viz ICH image analysis algorithm in terms of sensitivity and specificity with respect to a ground truth, as established by trained neuro-radiologists, in the detection of intracranial hemorrhage (ICH) in the brain. In addition, the study reported and compared the time to notification for the Viz ICH device with respect to the time to notification for the standard of care as established from available radiological reports.

261 non-contrast Computed Tomography (NCCT) scans (studies) were obtained from two clinical sites in the U.S.

The area under the receiver operating characteristic curve (AUC) was 0.96.

Sensitivity and specificity were 93% (87%-97%) and 90% (84%-94%), respectively. Because the lower bound of each confidence interval exceeded 80%, the study met the pre-specified performance goals of 80% for sensitivity and specificity.

In the study, the average time to alerting a specialist was 0.49±0.15 minutes, which is substantially lower than the average time to notification seen in the Standard of Care of 38.2±84.3 minutes. This data generally demonstrates that specialists have the opportunity to become involved in the clinical workflow early with notifications from the Viz ICH software.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Sensitivity: 93% (87%-97%)
Specificity: 90% (84%-94%)
AUC: 0.96

Performance Stratified by Clinical Site:
Erlanger: Sensitivity [95% CI] 0.93 [0.85, 0.98], Specificity [95% CI] 0.92 [0.84, 0.97]
Mt. Sinai: Sensitivity [95% CI] 0.92 [0.8, 0.98], Specificity [95% CI] 0.86 [0.75, 0.94]

Performance Stratified by Age:
70 years: Sensitivity [95% CI] 0.94 [0.84, 0.99], Specificity [95% CI] 0.88 [0.76, 0.95]

Performance Stratified by Gender:
Male: Sensitivity [95% Cl] 0.9 [0.8, 0.96], Specificity [95% CI] 0.9 [0.8, 0.96]
Female: Sensitivity [95% Cl] 0.95 [0.86, 0.99], Specificity [95% CI] 0.89 [0.8, 0.95]

Performance Stratified by ICH Subtype:
Intraparenchymal Hemorrhage (IPH): Sensitivity [95% CI] 0.98 [0.91, 1.0]
Intraventricular Hemorrhage (IVH): Sensitivity [95% CI] 1.00 [0.74, 1.0]
Subarachnoid Hemorrhage (SAH): Sensitivity [95% CI] 0.60 [0.26, 0.88]
Subdural Hemorrhage (SDH): Sensitivity [95% CI] 0.85 [0.62, 0.97]
Extradural Hemorrhage (EDH): N/A
SDH or EDH: Sensitivity [95% CI] 0.85 [0.62, 0.97]

Performance Stratified by Slice Thickness:
2.5mm

§ 892.2080 Radiological computer aided triage and notification software.

(a)
Identification. Radiological computer aided triage and notification software is an image processing prescription device intended to aid in prioritization and triage of radiological medical images. The device notifies a designated list of clinicians of the availability of time sensitive radiological medical images for review based on computer aided image analysis of those images performed by the device. The device does not mark, highlight, or direct users' attention to a specific location in the original image. The device does not remove cases from a reading queue. The device operates in parallel with the standard of care, which remains the default option for all cases.(b)
Classification. Class II (special controls). The special controls for this device are:(1) Design verification and validation must include:
(i) A detailed description of the notification and triage algorithms and all underlying image analysis algorithms including, but not limited to, a detailed description of the algorithm inputs and outputs, each major component or block, how the algorithm affects or relates to clinical practice or patient care, and any algorithm limitations.
(ii) A detailed description of pre-specified performance testing protocols and dataset(s) used to assess whether the device will provide effective triage (
e.g., improved time to review of prioritized images for pre-specified clinicians).(iii) Results from performance testing that demonstrate that the device will provide effective triage. The performance assessment must be based on an appropriate measure to estimate the clinical effectiveness. The test dataset must contain sufficient numbers of cases from important cohorts (
e.g., subsets defined by clinically relevant confounders, effect modifiers, associated diseases, and subsets defined by image acquisition characteristics) such that the performance estimates and confidence intervals for these individual subsets can be characterized with the device for the intended use population and imaging equipment.(iv) Stand-alone performance testing protocols and results of the device.
(v) Appropriate software documentation (
e.g., device hazard analysis; software requirements specification document; software design specification document; traceability analysis; description of verification and validation activities including system level test protocol, pass/fail criteria, and results).(2) Labeling must include the following:
(i) A detailed description of the patient population for which the device is indicated for use;
(ii) A detailed description of the intended user and user training that addresses appropriate use protocols for the device;
(iii) Discussion of warnings, precautions, and limitations must include situations in which the device may fail or may not operate at its expected performance level (
e.g., poor image quality for certain subpopulations), as applicable;(iv) A detailed description of compatible imaging hardware, imaging protocols, and requirements for input images;
(v) Device operating instructions; and
(vi) A detailed summary of the performance testing, including: test methods, dataset characteristics, triage effectiveness (
e.g., improved time to review of prioritized images for pre-specified clinicians), diagnostic accuracy of algorithms informing triage decision, and results with associated statistical uncertainty (e.g., confidence intervals), including a summary of subanalyses on case distributions stratified by relevant confounders, such as lesion and organ characteristics, disease stages, and imaging equipment.

0

March 18, 2020

Image /page/0/Picture/1 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.

Viz.ai, Inc. % Mr. Gregory Ramina Director of Regulatory Affairs 555 De Haro St., Suite 400 SAN FRANCISCO CA 94107

Re: K193658

Trade/Device Name: Viz ICH Regulation Number: 21 CFR 892.2080 Regulation Name: Radiological computer aided triage and notification software Regulatory Class: Class II Product Code: QAS Dated: March 2, 2020 Received: March 2, 2020

Dear Mr. Ramina:

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

1

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

2

510(k) Number (if known)

K193658

Device Name

Viz ICH

Indications for Use (Describe)

Viz ICH is a notification-only, parallel workflow tool for use by hospital networks and trained clinicians to identify and communicate images of specific patients to a specialist, independent of care workflow.

Viz ICH uses an artificial intelligence algorithm to analyze images for findings suggestive of a prespecified clinical condition and to notify an appropriate medical specialist of these findings in parallel to standard of care image interpretation. Identification of suspected findings is not for diagnostic use beyond notification. Specifically, the device analyzes non-contrast CT images of the brain acquired in the acute setting, and sends notifications to a neurovascular or neurosurgical specialist that a suspected intracranial hemorrhage has been identified and recommends review of those images. Images can be previewed through a mobile application.

lmages that are previewed through the mobile application may be compressed and are for informational purposes only and not intended for diagnostic use beyond notified clinicians are responsible for viewing non-compressed images on a diagnostic viewer and engaging in appropriate patient and relevant discussion with a treating physician before making care-related decisions or requests. Viz ICH is limited to analysis of imaging data and should not be used in-lieu of full patient evaluation or relied upon to make or confirm diagnosis.

Viz ICH is contraindicated for analyzing non-contrast CT scans that are acquired on scanners from manufacturers other than General Electric (GE) or its subsidiaries (i.e. GE Healthcare). This contraindication applies to NCCT scans that conform to all applicable Patient Inclusion Criteria, are of adequate technical image quality, and would otherwise be expected to be analyzed by the device for a suspected ICH.

Type of Use (Select one or both, as applicable)

区 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. 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."

3

510(k) SUMMARY

Viz.ai, Inc.'s Viz ICH

K193658

  • Applicant Name: Viz.ai, Inc. 555 De Haro St Suite 400 San Francisco, CA 94107
  • Contact Person: Gregory Ramina Director of Regulatory Affairs 555 De Haro St Suite 400 San Francisco, CA 94107 Tel. (415) 663-6130 Greg@viz.ai
  • Date Prepared: March 6, 2020

Device Name and Classification

Name of Device:Viz ICH
Common or Usual Name:Radiological Computer-Assisted Triage and Notification Software
Classification Panel:Radiology
Regulation No:21 C.F.R. § 892.2080
Regulatory Class:Class II
Product Code:QAS

Predicate Devices

ManufacturerDevice NameApplication No.
Viz.ai, Inc. (Primary)ContaCTDEN170073
Aidoc Medical, Ltd.BriefCaseK180647

Device Description

Viz ICH is a software-only, parallel workflow tool for use by hospital networks and trained clinicians to identify and communicate images of specific patients to an appropriate specialist, such as a neurovascular specialist or neurosurgeon, independent of the standard of care workflow. The system automatically receives and analyzes non-contrast CT (NCCT) studies of patients for image features that indicate the presence of an intracranial hemorrhage (ICH) using an artificial intelligence algorithm, and upon detection of a suspected ICH, sends a notification so as to alert a specialist clinician of the case.

4

Viz ICH consists of backend and mobile application component software. The Backend software includes a DICOM router and backend server. The DICOM router transmits NCCT images of the head acquired on a local healthcare network to the Backend Server. The Backend Server receives, stores, processes and serves received NCCT scans. The Backend Server also includes an artificial intelligence algorithm that analyzes the received NCCT images for image characteristics that indicate an intracranial haemorrhage (ICH) and, upon detection, sends a notification of the suspected finding to pre-determined specialists.

The Viz ICH Mobile Application software receives notifications generated by the Backend of suspected image findings and allows the notification recipient to view the analyzed NCCT images through a non-diagnostic viewer, as well as patient information that was embedded in the image metadata. Image viewing through the mobile application is for informational purposes only and is not intended for diagnostic use.

Intended Use / Indications for Use

Viz ICH is a notification-only, parallel workflow tool for use by hospital networks and trained clinicians to identify and communicate images of specific patients to a specialist, independent of standard of care workflow.

Viz ICH uses an artificial intelligence alqorithm to analyze images for findings suggestive of a prespecified clinical condition and to notify an appropriate medical specialist of these findings in parallel to standard of care image interpretation. Identification of suspected findings is not for diagnostic use beyond notification. Specifically, the device analyzes non-contrast CT images of the brain acquired in the acute setting, and sends notifications to a neurovascular or neurosurgical specialist that a suspected intracranial hemorrhage has been identified and recommends review of those images can be previewed through a mobile application.

lmages that are previewed through the mobile application may be compressed and are for informational purposes only and not intended for diagnostic use beyond notification. Notified clinicians are responsible for viewing non-compressed images on a diagnostic viewer and engaging in appropriate patient evaluation and relevant discussion with a treating physician before making care-related decisions or requests. Viz ICH is limited to analysis of imaging data and should not be used in-lieu of full patient evaluation or relied upon to make or confirm diagnosis.

Viz ICH is contraindicated for analyzing non-contrast CT scans that are acquired on scanners from manufacturers other than General Electric (GE) or its subsidiaries (i.e. GE Healthcare). This contraindication applies to NCCT scans that conform to all applicable Patient Inclusion Criteria, are of adequate technical image quality, and would otherwise be expected to be analyzed by the device for a suspected ICH.

Summary of Technological Characteristics

Viz ICH and its primary predicate, ContaCT (DEN170073), use the same process of automatic data identification and transfer to send images from the local hospital network to a

5

remote server for image processing and analysis, i.e., via a DICOM router that automatically identifies relevant images on a local IT Network and transfers them to a Backend Server using a DICOM compliant communication protocol.

Both Viz ICH and the ContaCT device have Backend Server software that can receive, store, process, and serve images that are forwarded from a DICOM router. The Backend Server software for each device has the same additional software functionality that interacts with the image management architecture, including a notifier module.

Where Viz ICH and the primary predicate differ, namely the specific condition and image modality analyzed by each device's algorithm. Viz ICH is similar to the secondary predicate. BriefCase (K180647), in that both software algorithms are designed to detect the same condition, intracranial haemorrhage (ICH), in non-contrast Computed Tomography images (NCCTs) of the head. Like the secondary predicate, BriefCase, the Viz ICH algorithm does not externalize any internal segmentation, analysis, or intermediate outputs used in determining if an ICH is present in the NCCT, nor does either algorithm mark the analyzed NCCT image.

Both Viz ICH and the ContaCT predicate support a mobile application that allows a user to receive push notifications, preview related images, and view patient details associated with a series. The Viz ICH mobile application is subject to the same non-diagnostic viewing limitations as the ContaCT predicate and has the same non-diagnostic warning on the image viewing screen as the predicate. Furthermore, the mobile application for Viz ICH and the ContaCT predicate can perform the same image viewing functions (window, pan, level, zoom, scroll through a cine).

Viz ICHContaCT (DEN170073)BriefCase (K180647)
Technological Characteristics
DICOM
CompatibleYesYesYes
Transfer, store,
and process
DICOM imagesYesYesYes
Data AcquisitionAcquires medical image data
from DICOM compliant
imaging devices and
modalities.Acquires medical image data
from DICOM compliant
imaging devices and
modalities.Acquires medical image data
from DICOM compliant
imaging devices and
modalities.
Image Analysis
Supported
Imaging ModalityComputed Tomography, non-
contrast (NCCT)Computed Tomography,
contrast-enhanced (CTA)Computed Tomography, non-
contrast (NCCT)
Alteration of
Original ImageNoNoNo
Results of Image
AnalysisInternal, no image markingInternal, no image markingInternal, no image marking
Image Viewing Functionality
Preview ImagesInitial assessment; non-
diagnostic purposesInitial assessment; non-
diagnostic purposesInitial assessment; non-
diagnostic purposes
View DICOM
DataDICOM Information about the
patient, study and current
image.DICOM Information about the
patient, study and current
image.DICOM Information about the
patient, study and current
image.
Image viewingYesYesYes

6

| and manipulation
(window, pan,

level, zoom)
-------------------------------------------------------

Performance Data

Viz.ai conducted a retrospective study to assess the standalone performance of the image analysis algorithm and notification functionality of Viz ICH. The study evaluated the Viz ICH image analysis algorithm in terms of sensitivity and specificity with respect to a ground truth, as established by trained neuro-radiologists, in the detection of intracranial hemorrhage (ICH) in the brain. In addition, the study reported and compared the time to notification for the Viz ICH device with respect to the time to notification for the standard of care as established from available radiological reports.

261 non-contrast Computed Tomography (NCCT) scans (studies) were obtained from two clinical sites in the U.S. There were approximately equal numbers of positive and negative cases (47% of images with ICH and 53% without ICH, respectively) included in the analysis. Sensitivity and specificity were calculated in the image database, comparing the Viz ICH's output to ground truth as established by trained neuro-radiologists. Sensitivity and specificity were 93% (87%-97%) and 90% (84%-94%), respectively. Because the lower bound of each confidence interval exceeded 80%, the study met the pre-specified performance goals of 80% for sensitivity and specificity.

In addition, the area under the receiver operating characteristic curve (AUC) was 0.96 demonstrating the clinical utility and potential benefits of the classifier based on the imaging study results.

7

Image /page/7/Figure/0 description: The image is a Receiver Operating Characteristic (ROC) curve for Viz ICH. The x-axis represents the false positive rate, and the y-axis represents the true positive rate. The ROC curve has an area of 0.96, and a threshold of 0.1 mL is marked with a dotted vertical line.

In the study, the average time to alerting a specialist was 0.49±0.15 minutes, which is substantially lower than the average time to notification seen in the Standard of Care of 38.2±84.3 minutes. This data generally demonstrates that specialists have the opportunity to become involved in the clinical workflow early with notifications from the Viz ICH software.

As part of a secondary analysis, the company stratified the device performance by various confounding variables:

Performance Stratified by Clinical Site
Clinical SiteSensitivity [95% CI]Specificity [95% CI]
Erlanger0.93 [0.85, 0.98]0.92 [0.84, 0.97]
Mt. Sinai0.92 [0.8, 0.98]0.86 [0.75, 0.94]
Performance Stratified by Age
Age Range (years)Sensitivity [95% CI]Specificity [95% CI]
700.94 [0.84, 0.99]0.88 [0.76, 0.95]

8

Performance Stratified by Gender
GenderSensitivity [95% Cl]Specificity [95% CI]
Male0.9 [0.8, 0.96]0.9 [0.8, 0.96]
Female0.95 [0.86, 0.99]0.89 [0.8, 0.95]
Performance Stratified by ICH Subtype
ICH SubtypeSensitivity [95% CI]
Intraparenchymal Hemorrhage (IPH)0.98 [0.91, 1.0]
Intraventricular Hemorrhage (IVH)1.00 [0.74, 1.0]
Subarachnoid Hemorrhage (SAH)0.60 [0.26, 0.88]
Subdural Hemorrhage (SDH)0.85 [0.62, 0.97]
Extradural Hemorrhage (EDH)N/A
SDH or EDH0.85 [0.62, 0.97]
Performance Stratified by Slice Thickness
Slice ThicknessSensitivitySpecificity
2.5mm