K Number
K221061
Device Name
21HQ613D
Date Cleared
2022-06-03

(53 days)

Product Code
Regulation Number
892.2050
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
This Medical Monitor is indicated for use in displaying radiological images (including full-field digital mammography and digital breast tomosynthesis) for review, and diagnosis by trained medical practitioners.
Device Description
The Medical monitor is intended to provide high resolution color and grayscale medical imaging for PACS and Radiology system. This Medical Monitor is intended to be used by trained medical practitioners for displaying, reviewing, and analysis of medical images
More Information

Not Found

No
The document describes a medical monitor for displaying images and mentions image processing, but there is no mention of AI, ML, or related terms like deep learning. The performance studies focus on display characteristics and software validation, not AI/ML model performance.

No.
The device is a medical monitor used for displaying radiological images for review and diagnosis, not for providing therapy.

Yes

This device is specifically indicated for "review, and diagnosis by trained medical practitioners" of radiological images, including mammography and tomosynthesis, which are used for diagnostic purposes. The device's function is to display these images for the purpose of making a diagnosis.

No

The device is described as a "Medical Monitor" and the performance studies include measurements related to hardware characteristics like spatial resolution, luminance, and pixel defects, indicating it is a physical display device, not software only.

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

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections. They are used to provide information for diagnosis, monitoring, or screening.
  • Device Function: The described device is a medical monitor used for displaying radiological images. Its function is to present visual information to a trained medical practitioner for review and diagnosis. It does not perform any tests on biological samples.
  • Intended Use: The intended use clearly states it's for "displaying radiological images... for review, and diagnosis." This is a display function, not an in vitro diagnostic test.
  • Device Description: The description reinforces that it's a "Medical monitor is intended to provide high resolution color and grayscale medical imaging for PACS and Radiology system."
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples, performing chemical reactions, or using reagents, which are typical characteristics of IVD devices.

Therefore, this device falls under the category of a medical imaging display device, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

This Medical Monitor is indicated for use in displaying radiological images (including full-field digital mammography and digital breast tomosynthesis) for review, and diagnosis by trained medical practitioners.

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

PGY

Device Description

The Medical monitor is intended to provide high resolution color and grayscale medical imaging for PACS and Radiology system. This Medical Monitor is intended to be used by trained medical practitioners for displaying, reviewing, and analysis of medical images

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Radiological images (including full-field digital mammography and digital breast tomosynthesis)

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Trained medical practitioners

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

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

Non-Clinical Test summary:

  1. Electrical Safety and Electromagnetic Compatibility: The test results demonstrated that the proposed device complies with IEC 60601-1:2005/AMD1:2012, IEC 60601-1-2 Edition 4.0:2014, and IEC 60601-1-6:2010/A1:2013.
  2. Software Validation: The 21HQ613D contains MODERATE level of concern software. The software was designed and developed according to a software development process and was verified and validated.
  3. Guidance: Performance items were tested according to "Display Devices for Diagnostic Radiology – Guidance for Industry and Food and Drug Administration Staff, issued on October 2, 2017". These items include Spatial resolution, Pixel defects, Artifacts, Temporal response, Luminance, Conformance to a grayscale-to-luminance fuction, Luminance at 30° and 45° in diagonal, horizontal, and vertical directions at center and four corners, Luminance uniformity or Mura test, Stability of luminance and chromaticity response with temperature and time of operation (on-time), Spatial noise, Reflection coefficient, Veiling glare or small-spot contrast, Color tracking, and Gray tracking.

Key results: According to the test results, there are no significant performance differences between 21HQ613D and the predicate devices that would adversely affect the use of the product. It has substantially equivalent performance compared to the predicate devices.

Clinical Test Summary: No clinical studies were considered necessary and performed.

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K172738, K201777

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 892.2050 Medical image management and processing system.

(a)
Identification. A medical image management and processing system is a device that provides one or more capabilities relating to the review and digital processing of medical images for the purposes of interpretation by a trained practitioner of disease detection, diagnosis, or patient management. The software components may provide advanced or complex image processing functions for image manipulation, enhancement, or quantification that are intended for use in the interpretation and analysis of medical images. Advanced image manipulation functions may include image segmentation, multimodality image registration, or 3D visualization. Complex quantitative functions may include semi-automated measurements or time-series measurements.(b)
Classification. Class II (special controls; voluntary standards—Digital Imaging and Communications in Medicine (DICOM) Std., Joint Photographic Experts Group (JPEG) Std., Society of Motion Picture and Television Engineers (SMPTE) Test Pattern).

0

Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA logo on the right. The FDA logo is in blue and includes the letters "FDA" followed by the words "U.S. FOOD & DRUG ADMINISTRATION" stacked on top of each other.

LG Electronics Inc. % Jonghyun Kim Chief Consultant GMS Consulting 4th Floor, Digital Cube, 34, Sangamsan-ro Seoul, Mapo-gu 03909 KOREA

Re: K221061

June 3, 2022

Trade/Device Name: 21HO613D Regulation Number: 21 CFR 892.2050 Regulation Name: Medical image management and processing system Regulatory Class: Class II Product Code: PGY Dated: April 7, 2022 Received: April 11, 2022

Dear Jonghyun Kim:

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

1

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,

For

Michael D. O'Hara, Ph.D. Deputy Director DHT 8C: Division of Radiological Imaging and Radiation Therapy Devices OHT 8: Office of Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K221061

Device Name 21HQ613D

Indications for Use (Describe)

This Medical Monitor is indicated for use in displaying radiological images (including full-field digital mammography and digital breast tomosynthesis) for review, and diagnosis by trained medical practitioners.

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

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

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510(k) Summary

[As Required by 21 CFR 807.92]

1. Date Prepared [21 CFR 807.92(a)(a)]

April 07, 2022

2. Submitter's Information [21 CFR 807.92(a)(1)]

• Name of Sponsor:LG Electronics Inc.
- Address:222, LG-ro, Cheongho-ri, Jinwi-myeon, Pyeongtaek-si,
Gyeonggi-do, 17709, Republic of Korea
• Contact Name:Jinhwan Jun / Chief Research Engineer
- Telephone No.:+82-31-8066-5641
- Email Address:jinhwan.jun@lge.com
• Name of Manufacturer:LG Electronics Inc.
- Address:77, Sanho-daero, Gumi-si, Gyeongsangbuk-do, 39381,

3. Trade Name, Common Name, Classification [21 CFR 807.92(a)(2)]

Trade Name:21HQ613D
-----------------------
  • Common Name: ●
    Medical Monitor

Republic of Korea

  • Classification: ●
Classification NameMedical image management and processing system.
Classification Number21 CFR 892.2050
Product CodePGY
Device ClassII
Review PanelRadiology

4

4. Identification of Predicate Device(s) [21 CFR 807.92(a)(3)]

The identified predicate devices within this submission are shown as follow;

K172738

RX560

EIZO Corporation

Medical image management and processing system.

Primary Predicate Device

510(k) Number:
------------------
  • Applicant:
  • Classification Name: ●
  • Trade Name: ●

Predicate Device

  • K201777 510(k) Number: Applicant: LG Electronics Classification Name: Medical image management and processing system. Trade Name: 31HN713D

5. Description of the Device [21 CFR 807.92(a)(4)]

The Medical monitor is intended to provide high resolution color and grayscale medical imaging for PACS and Radiology system. This Medical Monitor is intended to be used by trained medical practitioners for displaying, reviewing, and analysis of medical images

6. Indications for use [21 CFR 807.92(a)(5)]

This Medical Monitor is indicated for use in displaying radiological images (including full-field digital mammoqraphy and digital breast tomosynthesis) for review, analysis, and diagnosis by trained medical practitioners.

5

7. Technological Characteristics (Equivalence to Predicate Device) [21 CFR 807.92(a)(6)]

The table below presents comparisons between the subject device (21HQ613D) and the legally marketed predicate devices (K172738 and K201777):

Proposed DevicePrimary Predicate Device
K NumberNot knownK172738
ManufacturerLG Electronics Inc.EIZO Corporation
Model Name21HQ613DRX560
Classification NameMedical image management and
processing system.Medical image management and
processing system.
Classification Number21 CFR 892.205021 CFR 892.2050
Indications for UseThis Medical Monitor is indicated for use
in displaying radiological images
(including full-field digital mammography
and digital breast tomosynthesis) for
review, analysis, and diagnosis by trained
medical practitioners.This product is intended to be used in
displaying and viewing digital images,
including standard and multiframe digital
mammography, for review, analysis and
diagnosis by trained medical
practitioners. It is specially designed for
breast tomosynthesis applications.
Display TechnologyThe 21HQ613D has a TM213XDGP31
module for displaying. The
TM213XDGP31 is a " TFT Liquid Crystal
Display module with LED Backlight unit
and one 30pin eDP port and 4ch-LVDS
interface. This module supports
2048x2560 5M Pixel mode and can
display color driven by 10bit drivers. The
LCD module includes built-in converter
for BacklightThis is a color LCD monitor for viewing
digital images, including standard and
multiframe digital mammography, for
review, analysis and diagnosis. The color
panel employs in-plane switching (IPS)
technology allowing wide viewing angles
and the matrix size (or resolution) is
2048x2560 pixels.
Power ConsumptionMAX. 120W
Off Mode ≤ 0.3W87 W / Less than 1 W
Screen size473.4 x 364.5 mm337.9 mm x 422.4 mm
LCD ScreenTFT LCDTFT LCD
Pixel Pitch0.165 x 0.165 mm0.165 x 0.165 mm
Resolution2,048 x 2,560 pixels2,048 x 2,560
Horizontal Frequency30 kHz to 135kHz31 kHz to 135 kHz
Vertical Frequency24 Hz to 61 Hz59 Hz to 61 Hz
Input video signalsDVI IN x 1,
DP IN x 2
DP OUT x 1DVI x 1
DP IN x 1
DP OUT x 1

[Table 1. Comparison of Proposed Device to Primary Predicate Device]

The comparison table shows that the subject device (21HQ613D) has the similar indications for use the primary predicate device. Although the devices have some different technological characteristics (screen size, pixel pitch, Resolution, horizontal/vertical frequency and input video signals), these differences do not make the subject device less safe and reliable, so the subject device fits for diagnostic use as the predicate device does. There are no significant differences in the technological characteristics of the subject device. All the differences between the subject and predicate device do not raise different questions of safety and effectiveness. It is substantially equivalent to a predicate device in indications for use and technology characteristics.

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Proposed DevicePredicate Device
K NumberNot knownK201777
ManufacturerLG Electronics Inc.LG Electronics Inc.
Model Name21HQ613D31HN713D
Classification NameMedical image management and processing system.Medical image management and processing system.
Classification Number21 CFR 892.205021 CFR 892.2050
Indications for UseThis Medical Monitor is indicated for use in displaying radiological images (including full-field digital mammography and digital breast tomosynthesis) for review, analysis, and diagnosis by trained medical practitioners.This Medical Monitor is indicated for use in displaying radiological images (including full-field digital mammography and digital breast tomosynthesis) for review, analysis, and diagnosis by trained medical practitioners.
Display TechnologyThe 21HQ613D has a TM213XDGP31 module for displaying. The TM213XDGP31 is a " TFT Liquid Crystal Display module with LED Backlight unit and one 30pin eDP port and 4ch-LVDS interface. This module supports 2048x2560 5M Pixel mode and can display color driven by 10bit drivers. The LCD module includes built-in converter for BacklightThe 31HN713D has a LB310FTM module for displaying. The LB310FTM is a 31" TFT Liquid Crystal Display module with LED Backlight unit. This module supports 4,200 x 2,800 pixels and can display color driven by 10bit drivers.
Power ConsumptionMAX. 120W
Off Mode ≤ 0.3WMAX. 150W
Sleep Mode ≤ 0.5W
Off Mode ≤ 0.3W
Screen size473.4 x 364.5 mm676.9 x 459.7 mm
LCD ScreenTFT LCDTFT LCD
Pixel Pitch0.165 x 0.165 mm0.1554 x 0.1554 mm
Resolution2,048 x 2,560 pixels4,200 x 2,800 pixels
Horizontal Frequency30 kHz to 135kHz30 kHz to 135kHz
Vertical Frequency24 Hz to 61 Hz56 Hz to 61 Hz
Input video signalsDVI IN x 1,
DP IN x 2
DP OUT x 1DisplayPort x 2
HDMI x 1
[Table 2. Comparison of Proposed Device to Predicate Device]
----------------------------------------------------------------------

The comparison table shows that the subject device (21HQ613D) has the similar indications for use the predicate device. Although the devices have some different technological characteristics (screen size, pixel pitch, Resolution, horizontal/vertical frequency and input video signals), these differences do not make the subject device less safe and reliable, so the subject device fits for diagnostic use as the predicate device does. There are no significant differences in the technological characteristics of the subject device. All the differences between the subject and predicate device do not raise different questions of safety and effectiveness. It is substantially equivalent to a predicate device in indications for use and technology characteristics.

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8. Non-Clinical Test summary

    1. Electrical Safety and Electromagnetic Compatibility
      The test results demonstrated that the proposed device complies with the following standards:
  • · Electrical Basic Safety and Essential Performance reguirements in accordance with IEC 60601-1:2005/AMD1:2012

  • · Electromagnetic Compatibility Testing in accordance with IEC 60601-1-2 Edition 4.0:2014

  • · Medical Electrical Equipment Part 1-6: General Requirements for Basic Safety and Essential Performance - Collateral Standard: Usability in accordance with IEC 60601-1-6:2010/A1:2013

    1. Software Validation

The 21HQ613D contains MODERATE level of concern software. The software was designed and developed according to a software development process and was verified and validated.

The software information is provided in accordance with FDA guidance: The content of premarket submissions for software contained in medical devices, on May 11, 2005.

    1. Guidance
      Display Devices for Diagnostic Radiology – Guidance for Industry and Food and Drug Administration Staff, issued on October 2, 2017
MeasurementsDescriptionSE Note
a.Spatial resolutionMeasurements of the transfer of
information from the image data to the
luminance fields at different spatial
frequencies of interest typically done by
reporting the modulation transfer
function. Non-isotropic resolution
properties should be characterized
properly by providing two-dimensional
measurements or measurements along
at least two representative axes.
(Using TG18 QC Test Pattern)Equivalent
b.Pixel defectsMeasurements (count, types (e.g., sub-
pixel or entire pixel, always-on, always-
off), and locations (map) of pixel
defects. This is typically provided as a
tolerance limit. Pixel defects can
interfere with the visibility of small
details in medical images.Equivalent
c.ArtifactsEvaluate for image artifacts such as
ghosting and/or image sticking from
displaying a fixed test pattern for a
period of time.
(Using 5x5 mosaic pattern, 64Gray /
127 Gray judgment)Same
d.Temporal responseMeasurements of the temporal behavior
of the display in responding to changes
in image values from frame to frame.
Since these transitions are typically not
symmetric, rise and fall time constantsEquivalent
MeasurementsDescriptionSE Note
are needed to characterize the system.
Slow displays can alter details and
contrast of the image when large image
stacks are browsed or in video,
panning, and zooming modes.
e.LuminanceMeasurements of the maximum and
minimum luminance that the device
outputs as used in the application under
recommended conditions and the
achievable values if the device is set to
expand the range to the limit.Same
f.Conformance to a
grayscale-to-luminance
functionMeasurements of the mapping between
image values and the luminance output
following a target model response for
256 or more levels.Equivalent
g.Luminance at 30° and 45°
in diagonal, horizontal,
and vertical directions at
center and four cornersMeasurements of the luminance
response at off-normal viewing related
to the target model for the luminance
response.Equivalent
h.Luminance uniformity or
Mura testMeasurements of the uniformity of the
luminance across the display screen.Equivalent
i.Stability of luminance and
chromaticity response
with temperature and time
of operation (on-time)Measurements of the change in
luminance and chromaticity response
with temperature and use time.Same
j.Spatial noiseMeasurements of the spatial noise level
as represented by the noise power
spectrum using an appropriate ratio of
camera and display pixels. Spatial noise
and resolution affect the way images
are presented to the viewer and can
alter features that are relevant to the
interpretation process of the physician
or radiologist.Equivalent
k.Reflection coefficientMeasurements of the reflection
coefficients of the display device.
Specular and diffuse reflection
coefficients can be used as surrogates
for the full bidirectional reflection
distribution function.Same
l.Veiling glare or small-spot
contrastMeasurements of the contrast obtained
for small targets.Equivalent
m.Color trackingChromaticity at different luminance
levels of primary colors as indicated by
the color coordinates in an appropriate
units system (e.g., CIE u'v') and the
color gamut enveloped by the primary
colors.Equivalent
n.Gray trackingChromaticity at different luminance
levels of gray shades, including the
white point, as indicated by the color
coordinates in an appropriate units
systemEquivalent

According to the guidance, we test following performance items:

8

9

According to the above test results, there are no significant performance differences between 21HQ613D and the predicate devices that would adversely affect the use of the product. It has substantially equivalent performance compared to the predicate devices.

Clinical Test Summary:

No clinical studies were considered necessary and performed.

9. Conclusion [21 CFR 807.92(b)(3)]

In according with the Federal Food & Drug and cosmetic Act, 21 CFR Part 807, and based on the information provided in this premarket notification LG Electronics, concludes that the 21HQ613D is substantially equivalent in safety and effectiveness to the predicate devices as described herein.