K Number
K203042
Device Name
Aquilion Exceed LB (TSX-202A/3) V10.6 with AiCE-I
Date Cleared
2020-12-10

(65 days)

Product Code
Regulation Number
892.1750
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
This device is indicated to acquire and display cross-sectional volumes of the whole body, to include the head. The Aquilion Exceed LB has the capability to provide volume sets. These volume sets can be used to perform specialized studies, using indicated software/hardware, by a trained and qualified physician. AiCE (Advanced Intelligent Clear-IQ Engine) is a noise reduction algorithm that improves image quality and reduces image noise by employing Deep Convolutional Network methods for abdomen, pelvis, lung, extremities, head and inner ear applications.
Device Description
Aquilion Exceed LB (TSX-202A/3) V10.6 with AiCE-i (Advanced intelligent Clear-IQ Engineintegrated) is a whole body multi-slice helical CT scanner, consisting of a gantry, couch and a console used for data processing and display. This device captures cross sectional volume data sets used to perform specialized studies, using indicated software, by a trained and qualified physician. This system is based upon the technology and materials of previously marketed Canon CT systems. In addition, the subject device incorporates the latest reconstruction technology, AiCE-i (Advanced intelligent Clear-IQ Engine - integrated), intended to reduce image noise and improve image quality by utilizing Deep Convolutional Network methods. These methods can more fully explore the statistical properties of the signal and noise. By learning to differentiate structure from noise, the algorithm produces fast, high quality CT reconstruction. The AiCE algorithm has not been modified or retrained since the previous clearance in the predicate, K192832.
More Information

Yes
The device description explicitly mentions "AiCE (Advanced Intelligent Clear-IQ Engine)" which utilizes "Deep Convolutional Network methods" for image reconstruction and noise reduction. Deep Convolutional Networks are a type of machine learning algorithm.

No
The device is described as a CT scanner indicated to acquire and display cross-sectional volumes of the body and improve image quality through noise reduction. It is a diagnostic imaging device, not one that directly treats a condition.

Yes

The device "acquires and displays cross-sectional volumes" which are then "used to perform specialized studies, using indicated software/hardware, by a trained and qualified physician." This process of gathering and presenting anatomical data for a physician's analysis aligns with the function of a diagnostic device.

No

The device description explicitly states it is a "whole body multi-slice helical CT scanner, consisting of a gantry, couch and a console used for data processing and display," which are hardware components. While it includes software (AiCE-i), it is not solely software.

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

Here's why:

  • Intended Use: The intended use describes acquiring and displaying cross-sectional volumes of the body for specialized studies performed by a physician. This is a diagnostic imaging device, not a device used to examine specimens derived from the human body (like blood, urine, or tissue) to provide information for diagnosis, monitoring, or treatment.
  • Device Description: The description clearly states it's a "whole body multi-slice helical CT scanner." CT scanners are imaging devices, not IVDs.
  • Input Imaging Modality: The input is "Computed Tomography X-ray," which is an imaging modality, not a method for analyzing biological specimens.
  • Performance Studies: The performance studies focus on image quality metrics, dose reduction, spatial resolution, noise, and low contrast detectability, all of which are relevant to the performance of an imaging device. There are no studies related to the analysis of biological samples.

IVD devices are specifically designed to perform tests on samples taken from the body, whereas this device is designed to image the body itself.

No
The provided text does not contain any explicit statement that the FDA has reviewed and approved or cleared a Predetermined Change Control Plan (PCCP) for this specific device. The 'Control Plan Authorized (PCCP) and relevant text' section explicitly states "Not Found".

Intended Use / Indications for Use

This device is indicated to acquire and display cross-sectional volumes of the whole the head. The Aquilion Exceed LB has the capability to provide volume sets can be used to perform specialized studies, using indicated software/hardware, by a trained and qualified physician.

AiCE (Advanced Intelligent Clear-IQ Engine) is a noise reduction that improves image quality and reduces image noise by employing Deep Convolutional Network methods for abdomen, pelvis, lung, extremities, head and inner ear applications.

Product codes

JAK

Device Description

Aquilion Exceed LB (TSX-202A/3) V10.6 with AiCE-i (Advanced intelligent Clear-IQ Engineintegrated) is a whole body multi-slice helical CT scanner, consisting of a gantry, couch and a console used for data processing and display. This device captures cross sectional volume data sets used to perform specialized studies, using indicated software, by a trained and qualified physician. This system is based upon the technology and materials of previously marketed Canon CT systems.

In addition, the subject device incorporates the latest reconstruction technology, AiCE-i (Advanced intelligent Clear-IQ Engine - integrated), intended to reduce image noise and improve image quality by utilizing Deep Convolutional Network methods. These methods can more fully explore the statistical properties of the signal and noise. By learning to differentiate structure from noise, the algorithm produces fast, high quality CT reconstruction. The AiCE algorithm has not been modified or retrained since the previous clearance in the predicate, K192832.

Mentions image processing

Yes

Mentions AI, DNN, or ML

Yes

Input Imaging Modality

Computed Tomography X-ray system

Anatomical Site

whole body, to include the head, abdomen, pelvis, lung, extremities, and inner ear.

Indicated Patient Age Range

Not Found

Intended User / Care Setting

trained and qualified physician

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

Performance Testing - Bench
Image Quality Evaluation:
CT image quality metrics were performed, utilizing phantoms, to assess Contrast-to-Noise Ratios (CNR), CT Number Accuracy, Uniformity, Slice Sensitivity Profile (SSP), Modulation Transfer Function (MTF), Standard Deviation of Noise (SD) and Noise Power Spectra (NPS). It was concluded that the Aquilion Exceed LB system demonstrated substantially equivalent or improved performance relative to the predicate device as demonstrated by the results of the above testing.

Dose Reduction with AiCE:
A phantom study was conducted using the MITA-FDA LCD Body phantom and the results demonstrated a dose reduction of up 82% for AiCE Abdomen, relative to FBP.

Quantitative Spatial Resolution:
A comparison study was conducted, utilizing phantoms, in order to support a quantitative spatial resolution improvement claim of improved high contrast spatial resolution and simultaneous 50% noise reduction with AiCE Body STD.

Noise Texture:
An analysis of the NPS and kurtosis values for FBP, FIRST and AiCE was conducted and the results of the study support the following claim, noise appearance/texture is more similar to high dose filtered backprojection, compared to MBIR.

Quantitative Body LCD and Noise Improvement:
A phantom study was conducted using the MITA-FDA LCD Body phantom and the results demonstrated 1) 63% improved low contrast detectability and noise reduction of 57.8% with AIDR at the same dose for body compared to FBP and 2) 87% improved low contrast detectability and noise reduction of 67.2% with AiCE at the same dose for body compared to FBP.

PUREViSION Optics:
Phantom studies were conducted using the MITA-FDA LCD Body phantom and the results demonstrated 22% improved in low-contrast detectability and dose reduction of 27.5% at the same dose for Body CT and improved low contrast detectability at the same dose for Brain CT.

Key Metrics

Not Found

Predicate Device(s)

K192832

Reference Device(s)

K150003

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.

0

December 10, 2020

Image /page/0/Picture/1 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health and Human Services seal on the left and the FDA acronym and name on the right. The seal is a stylized depiction of an eagle and a caduceus, while the FDA acronym and name are written in blue, with the word "Administration" appearing below the acronym and name.

Canon Medical Systems Corporation % Orlando Tadeo, Jr. Sr. Manager, Regulatory Affairs Canon Medical Systems USA, Inc. 2441 Michelle Drive TUSTIN CA 92780

Re: K203042

Trade/Device Name: Aquilion Exceed LB (TSX-202A/3) V10.6 with AiCE-i Regulation Number: 21 CFR 892.1750 Regulation Name: Computed tomography x-ray system Regulatory Class: Class II Product Code: JAK Dated: October 5, 2020 Received: October 6, 2020

Dear Mr. Tadeo:

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 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

1

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 mediation-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

Indications for Use

510(k) Number (if known)

K203042

Device Name Aquilion Exceed LB (TSX-202A/3) V10.6 with AiCE-i

Indications for Use (Describe)

This device is indicated to acquire and display cross-sectional volumes of the whole the head. The Aquilion Exceed LB has the capability to provide volume sets can be used to perform specialized studies, using indicated software/hardware, by a trained and qualified physician.

AiCE (Advanced Intelligent Clear-IQ Engine) is a noise reduction that improves image quality and reduces image noise by employing Deep Convolutional Network methods for abdomen, pelvis, lung, extremities, head and inner ear applications.

X Prescription Use (Part 21 CFR 801 Subpart D)

Over-The-Counter Use (21 CFR 801 Subpart C)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff(@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

3

K203042

510(k) SUMMARY

  1. SUBMITTER'S NAME: Canon Medical Systems Corporation 1385 Shimoishigami Otawara-Shi, Tochigi-ken, Japan 324-8550
    1. OFFICIAL CORRESPONDENT: Fumiaki Teshima Senior Manager, Quality Assurance Department
    1. ESTABLISHMENT REGISTRATION: 9614698

4. CONTACT PERSON:

Orlando Tadeo, Jr. Sr. Manager, Regulatory Affairs Canon Medical Systems USA, Inc 2441 Michelle Drive Tustin, CA 92780 (714) 669-7459

  • ട. DATE PREPARED:
    October 5, 2020

    1. TRADE NAME(S): Aquilion Exceed LB (TSX-202A/3) V10.6 with AiCE-i

7. COMMON NAME:

System, X-ray, Computed Tomography

8. DEVICE CLASSIFICATION:

a) Classification Name: Computed Tomography X-ray system b) Regulation Number: 21 CFR §892.1750 c) Regulatory Class: Class II

9. PRODUCT CODE / DESCRIPTION:

90JAK / Computed Tomography X-Ray System

10. PERFORMANCE STANDARD:

This device conforms to applicable Performance Standards for Ionizing Radiation Emitting Products [21 CFR, Subchapter J, Part 1020]

PHONE: 800-421-1968 2441 Michelle Drive, Tustin, CA 92780

4

11. PREDICATE DEVICE:

ProductMarketed byRegulation NumberRegulation NameProduct Code510(k) NumberClearance Date
Primary:
Aquilion Prime SP
(TSX-303B/8) V10.2
with AiCE-iCanon
Medical
Systems, USA21 CFR
§892.1750Computed
Tomography
X-ray SystemJAK:
System, X-ray,
Tomography,
ComputedK19283202/21/2020
Reference Device:
Aquilion LB, TSX-
201A/3, V6.0Canon
Medical
Systems, USA21 CFR
§892.1750Computed
Tomography
X-ray SystemJAK:
System, X-ray,
Tomography,
ComputedK15000303/19/2015

12. REASON FOR SUBMISSION:

New device

13. DEVICE DESCRIPTION:

Aquilion Exceed LB (TSX-202A/3) V10.6 with AiCE-i (Advanced intelligent Clear-IQ Engineintegrated) is a whole body multi-slice helical CT scanner, consisting of a gantry, couch and a console used for data processing and display. This device captures cross sectional volume data sets used to perform specialized studies, using indicated software, by a trained and qualified physician. This system is based upon the technology and materials of previously marketed Canon CT systems.

In addition, the subject device incorporates the latest reconstruction technology, AiCE-i (Advanced intelligent Clear-IQ Engine - integrated), intended to reduce image noise and improve image quality by utilizing Deep Convolutional Network methods. These methods can more fully explore the statistical properties of the signal and noise. By learning to differentiate structure from noise, the algorithm produces fast, high quality CT reconstruction. The AiCE algorithm has not been modified or retrained since the previous clearance in the predicate, K192832.

14. INDICATIONS FOR USE:

This device is indicated to acquire and display cross-sectional volumes of the whole body, to include the head. The Aquilion Exceed LB has the capability to provide volume sets. These volume sets can be used to perform specialized studies, using indicated software/hardware, by a trained and qualified physician.

AiCE (Advanced Intelligent Clear-IQ Engine) is a noise reduction algorithm that improves image quality and reduces image noise by employing Deep Convolutional Network methods for abdomen, pelvis, lung, extremities, head and inner ear applications.

15. SUBSTANTIAL EQUIVALENCE:

The Aquilion Exceed LB (TSX-202A/3) V10.6 with AiCE-i is substantially equivalent to Aquilion Prime SP (TSX-303B/8) V10.2 with AiCE-i, which received premarket clearance under K192832, and is marketed by Canon Medical Systems USA. The intended use of the Aquilion Exceed LB is the same as that of the predicate device. Additionally, Aquilion LB (TSX-201A/3) V6.0, is included in this submission as a Reference Device due to its similarity with the subject device with regard to the gantry size opening of 900mm. A comparison of the technological characteristics between the subject and the predicate device is included below.

5

Subject DevicePrimary Predicate Device
Device Name,
Model NumberAquilion Exceed LB
(TSX-202A/3) V10.6 with AiCE-iAquilion Prime SP (TSX-303B/8)
V10.2 with AiCE-i
510(k) NumberThis submissionK192832
Scan (Rotation) time(0.26), 0.4, 0.45, 0.5, 0.6, 0.75,
1, 1.5, 2, 3 s(0.23), 0.35, 0.375, 0.4, 0.45,
0.5, 0.6, 0.75, 1, 1.5, 2, 3 s
View rateMax. 2400 views/s (0.5 s)Max. 2572 views/s (0.35 s)
Scan field diameter
(Field of View)320/550/700 mm320/500 mm
Extended Field of ViewAvailableAvailable
Gantry opening diameter900 mm780 mm
Gantry tiltNo tilt±30°
Axial and helical scanning
Gantry and remote controlled
Wedge Filter TypesTwo types
Small: FOV M
Large: FOV L and XLTwo types
Small: FOV M
Large: FOV L
DetectorPURE ViSION detectorPURE ViSION detector
Data acquisition1136 channels × 80 rows896 channels × 80 rows
X-ray generation
• Channel-direction (fan) angle52.2°49.2°
• Slide-direction (cone) angle3.22°3.8°
• Rated outputMax.72 kWMax.72 kW
• X-ray tube voltage80/100/120/135 kV80/100/120/135 kV
• X-ray tube current10-500 mA (10-600 mA)10-500 mA (10-600 mA)
• X-ray tube heat capacity7.5 MHU7.5 MHU
• X-ray tube cooling rateMax. 1,386 kHU/min (16.5 kW)
Actual 1,008 kHU/min (12.0 kW)Max. 1,386 kHU/min (16.5 kW)
Actual 1,008 kHU/min (12.0 kW)
Metal Artifact ReductionSingle Energy Metal Artifact
Reduction (SEMAR)Single Energy Metal Artifact
Reduction (SEMAR)
Noise reduction processing• Quantum Denoising Software
(QDS)
• Adaptive Integrative Dose
Reduction 3D (AIDR 3D)
• AIDR 3D Enhanced
• AiCE (Body, Lung, Bone, Brain,
Inner Ear)• Quantum Denoising Software
(QDS)
• Adaptive Integrative Dose
Reduction 3D (AIDR 3D)
• AIDR 3D Enhanced
• AiCE (Body, Lung, Cardiac,
Bone, Brain, Inner Ear)
Respiratory-gating systemAvailableAvailable
Couch lateral movement+85mm+42mm

16. SAFETY:

The device is designed and manufactured under the Quality System Regulations as outlined in 21 CFR § 820 and ISO 13485 Standards. This device is in conformance with the applicable parts of the following standards IEC60601-1-1, IEC60601-1-1, IEC60601-1-3, IEC60601-1-3, IEC60601-1-6, IEC60601-1-9, IEC60601-2-28, IEC60601-2-44, IEC60825-1, IEC62304, IEC62366, NEMA XR-25, NEMA XR-26 and NEMA XR-29. Additionally, this device complies with all applicable requirements of the radiation safety performance standards, as outlined in 21 CFR §1010 and §1020.

6

This device conforms to applicable Performance Standards for Ionizing Radiation Emitting Products [21 CFR, Subchapter J, Part 1020]

17. TESTING

Risk analysis and verification/validation activities conducted through bench testing demonstrate that the established specifications for the device have been met. These studies compared both FBP and AiCE reconstructions in the predicate and subject devices.

Performance Testing - Bench

Image Quality Evaluation

CT image quality metrics were performed, utilizing phantoms, to assess Contrast-to-Noise Ratios (CNR), CT Number Accuracy, Uniformity, Slice Sensitivity Profile (SSP), Modulation Transfer Function (MTF), Standard Deviation of Noise (SD) and Noise Power Spectra (NPS). It was concluded that the Aquilion Exceed LB system demonstrated substantially equivalent or improved performance relative to the predicate device as demonstrated by the results of the above testing.

Dose Reduction with AiCE

A phantom study was conducted using the MITA-FDA LCD Body phantom and the results demonstrated a dose reduction of up 82% for AiCE Abdomen, relative to FBP.

Quantitative Spatial Resolution

A comparison study was conducted, utilizing phantoms, in order to support a quantitative spatial resolution improvement claim of improved high contrast spatial resolution and simultaneous 50% noise reduction with AiCE Body STD.

Noise Texture

An analysis of the NPS and kurtosis values for FBP, FIRST and AiCE was conducted and the results of the study support the following claim, noise appearance/texture is more similar to high dose filtered backprojection, compared to MBIR.

Quantitative Body LCD and Noise Improvement

A phantom study was conducted using the MITA-FDA LCD Body phantom and the results demonstrated 1) 63% improved low contrast detectability and noise reduction of 57.8% with AIDR at the same dose for body compared to FBP and 2) 87% improved low contrast detectability and noise reduction of 67.2% with AiCE at the same dose for body compared to FBP.

PUREViSION Optics

Phantom studies were conducted using the MITA-FDA LCD Body phantom and the results demonstrated 22% improved in low-contrast detectability and dose reduction of 27.5% at the same dose for Body CT and improved low contrast detectability at the same dose for Brain CT.

Representative clinical images were not necessary to demonstrate substantial equivalence of the subject device.

7

Software Documentation for a Moderate Level of Concern, per the FDA guidance document, "Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices Document" issued on May 11, 2005, is also included as part of this submission.

Cybersecurity documentation, per the FDA cybersecurity premarket guidance document "Content of Premarket Submissions for Management of Cybersecurity in Medical Devices " issued on October 2, 2014, is also included as part of this submission.

Additionally, testing of the subject device was conducted in accordance with the applicable standards published by the International Electrotechnical Commission (IEC) for Medical Devices and CT Systems.

18. CONCLUSION

The Aquilion Exceed LB (TSX-202A/3) V10.6 with AiCE-i performs in a manner similar to and is intended for the same use as the predicate device, as indicated in product labeling. Based upon this information, conformance to standards, successful completion of software validation, application of risk management and design controls and the performance data presented in this submission it is concluded that the subject device has demonstrated substantial equivalence to the predicate device and is safe and effective for its intended use.